Petretta M, Cavallaro V, Bianchi V, La Mura G, Conforti G, Breglio R, Valva G, Morgano G, Bonaduce D
Istituto di Medicina Interna, Cardiologia e Cardiochirurgia, II Facoltà di Medicina e Chirurgia, Università Degli Studi di Napoli Federico II.
G Ital Cardiol. 1991 Nov;21(11):1167-77.
The relationships between echocardiographic and electrocardiographic variations and the sensibility of three different electrocardiographic criteria of left ventricular (LV) hypertrophy were assessed during deconditioning in 18 top-level oarsmen (mean age 23 +/- 4 years). After seven months of training and on the 7th and 21st deconditioning days the oarsmen underwent clinical examination, electrocardiogram (ECG) and echocardiogram with Doppler evaluation. The following ECG measurements were obtained: heart rate (HR), QTc, QRS and T waves axes, QRS and T wave angular gradients, R, S and T wave amplitude and T wave area. Moreover, the sums of S wave in lead V1 plus R wave in lead V5 or V6, of S wave in lead V1 or V2 plus R wave in lead V5 or V6, and of R wave in lead aVL plus S wave in lead V3 were calculated as indices of left ventricular hypertrophy. The following echocardiographic parameters were also analyzed: intraventricular septal (IVST) and posterior wall thickness (PWT), LV internal diameter (LVID), left ventricular mass (LVM) and volumes, LV endocardial/epicardial diastolic surface area ratio, peak systolic meridional wall stress (PSS), end-systolic stress (ESS) and mean systolic wall stress (MWSI), LV ejection fraction (EF) and total peripheral resistances (TPR); early (E) and late (A) transmitral peak flow velocity, E/A ratio. Systolic blood pressure was reduced after 3 deconditioning weeks, while diastolic blood pressure and HR were unchanged. Left ventricular mass and end-systolic volume were reduced after 1 week, while LV end-diastolic volume only after 3 weeks; therefore, EF improved at the end of the first week when TPR were lower. End-systolic stress always remained unchanged; PSS increased at 1 week and then returned to previous values. In addition, the endocardial-epicardial area ratio increased after 1 week and then returned to starting values after 3 weeks. Doppler parameters were in the normal range and remained unchanged during the study. Amplitudes of R wave in aVL, V5, V6 and of S wave in V2 did not change, while S wave amplitude in V1 and V3 decreased after three weeks and one week, respectively. The most sensible criterion for LV hypertrophy was the sum of S wave in V1 or V2 plus R wave in V5 or V6 (range from 33.3% to 22.2%); the sum of S in V1 plus R in V5 or V6 performed better than the sum of R in aVL plus S in V3.(ABSTRACT TRUNCATED AT 400 WORDS)
在18名顶级划桨运动员（平均年龄23±4岁）的体能下降期间，评估了超声心动图和心电图变化之间的关系，以及三种不同的左心室肥厚心电图标准的敏感性。经过7个月的训练后，在体能下降的第7天和第21天，这些划桨运动员接受了临床检查、心电图（ECG）和多普勒超声心动图检查。获得了以下心电图测量值：心率（HR）、QTc、QRS和T波轴、QRS和T波角梯度、R、S和T波振幅以及T波面积。此外，计算了V1导联S波加V5或V6导联R波的总和、V1或V2导联S波加V5或V6导联R波的总和以及aVL导联R波加V3导联S波的总和，作为左心室肥厚的指标。还分析了以下超声心动图参数：室间隔（IVST）和后壁厚度（PWT）、左心室内径（LVID）、左心室质量（LVM）和容积、左心室心内膜/心外膜舒张表面积比；收缩期峰值子午线壁应力（PSS）、收缩末期应力（ESS）和平均收缩期壁应力（MWSI）、左心室射血分数（EF）和总外周阻力（TPR）；二尖瓣早期（E）和晚期（A）峰值流速、E/A比值。体能下降3周后收缩压降低，而舒张压和心率不变。左心室质量和收缩末期容积在1周后降低，而左心室舒张末期容积仅在3周后降低；因此，当TPR较低时，EF在第一周结束时改善。收缩末期应力始终保持不变；PSS在1周时增加，然后恢复到先前的值。此外，心内膜-心外膜面积比在1周后增加，然后在3周后恢复到初始值。多普勒参数在正常范围内，在研究期间保持不变。aVL、V5、V6导联R波振幅和V2导联S波振幅没有变化，而V1导联S波振幅和V3导联S波振幅分别在3周和1周后降低。左心室肥厚最敏感的标准是V1或V2导联S波加V5或V6导联R波的总和（范围从33.3%到22.2%）；V1导联S波加V5或V6导联R波的总和比aVL导联R波加V3导联S波的总和表现更好。（摘要截断于400字）
