[Significance of some minor electrocardiographic disorders of repolarization].
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Biomedical subjects
Publications and source records attributed to P Stoiculescu.
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The electric stimulation of the lateral ventricular walls carried out in experiments on dog heart (open-thorax), as well as the analysis of the clinical, radiological and electrocardiographic data recorded in 462 cases with QRS macrovoltage led to the following conclusions: a) in 22% of the cases (hospital cardiologic examinations) this anomaly cannot be accounted for either by age, blood pressure or cardiac hypertrophy; b) a temporarily perturbed development of the ventricular depolarization, i.e. a "jerky" depolarization, not stagnant enough to produce an intraventricular block, may generate great negativity and positivity myocardial masses responsible for the appearance of large dipoles, namely of the increased QRS voltage; c) the coincident ischemia and macrovoltage of the QRS major wave, as well as the subsequent evolution of incipient CHD in a series of patients point to the hypothesis according to which the regional myocardial ischemia may induce a QRS macrovoltage by means of the above mechanism.
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Prolonged QT interval in patients with old myocardial infarction was noticed as a marker of poor prognosis. The sensitivity of this functional electrocardiographic scar was augmented in 82 patients with old myocardial infarction by recording the recumbent and orthostatic electrocardiogram, phonocardiogram and carotid piezogram. The incidence of abnormally prolonged QT intervals and increased QT ratios was three times higher in orthostatic posture than in patients lying down. Abnormal QT intervals in standing position correlate also with abnormal PEP/L VET ratio and severe electrocardiographic alterations and may become a useful tool for a more accurate prognosis in patients with old myocardial infarction.
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