Russo R, Rizzoli G, Stritoni P, Seminara G, Rubino M, Brumana T
Int J Cardiol. 1987 Feb;14(2):137-43. doi: 10.1016/0167-5273(87)90003-9.
The effect of systolic and diastolic overload of the left ventricle on the T wave was studied in 86 patients with pure aortic stenosis and in 82 patients with pure aortic insufficiency documented by hemodynamic investigation. All patients had hemodynamically significant, chronic isolated aortic valve disease with electrocardiographic evidence of left ventricular hypertrophy (Sokolow index greater than or equal to 45 mm). All had undergone selective coronary angiography. Flattened or negative T waves were present in 44 patients with aortic stenosis (51%) and in 66 (80%) with aortic incompetence. Inversion of the T wave in left ventricular leads was unrelated to the presence of ventricular conduction disturbances or to coronary artery disease or to low cardiac index. It was significantly related to older age (P = 0.0001) and, in patients with aortic incompetence, to the end-diastolic volume (P = 0.04). Digitalis intake was a nonsignificant (P = 0.10) independent variable. These findings suggest that patients with aortic stenosis cannot be distinguished from patients with aortic incompetence by the electrocardiogram and that the theory of Cabrera and Monroy is not valid in this set of patients.
在86例经血流动力学检查确诊为单纯主动脉瓣狭窄的患者和82例单纯主动脉瓣关闭不全的患者中，研究了左心室收缩期和舒张期负荷过重对T波的影响。所有患者均患有血流动力学显著的慢性孤立性主动脉瓣疾病，并有左心室肥厚的心电图证据（索科洛夫指数大于或等于45mm）。所有患者均接受了选择性冠状动脉造影。44例主动脉瓣狭窄患者（51%）和66例主动脉瓣关闭不全患者（80%）出现T波低平或倒置。左心室导联T波倒置与心室传导障碍、冠状动脉疾病或低心指数无关。它与年龄较大显著相关（P = 0.0001），在主动脉瓣关闭不全患者中，与舒张末期容积相关（P = 0.04）。服用洋地黄是一个无显著意义的（P = 0.10）独立变量。这些发现表明，通过心电图无法区分主动脉瓣狭窄患者和主动脉瓣关闭不全患者，并且卡布雷拉和蒙罗伊的理论在这组患者中无效。
