Das G, Collins J, Weissler A M
J Electrocardiol. 1981;14(2):109-14. doi: 10.1016/s0022-0736(81)80044-1.
Initial electrical forces emanating from interventricular septal depolarization, being directed to the right and anteriorly, normally produce an initial negative deflection or Q wave in leads I, aVL and V6 and an initial positive deflection or R wave in leads V1 and V2. The observations of hypertrophied interventricular septum, an integral part of the left ventricle, in patients with left ventricular hypertrophy would predict an increase in these septal electrical forces similar to the total left ventricular (QRS) forces in these subjects. Contrary to this expectation, several studies document an actual decrease or absence of the normally oriented initial forces in ECGs of patients with the criteria of left ventricular hypertrophy. In order to clarify the nature of this paradox, this study was initiated. Our observations suggest that the normal initial septal forces indeed increase as expected, during the initial four to six years, and subsequently show a progressive decline in patients with left ventricular hypertrophy. Although the precise mechanism for the bimodal change in the septal forces during the period of the constancy of the total QRS forces is not clear, a hypothesis based on the current knowledge is advanced to explain these observations.
源自室间隔去极化的初始电力，方向向右且向前，正常情况下在I导联、aVL导联和V6导联产生初始负向偏转或Q波，在V1导联和V2导联产生初始正向偏转或R波。在左心室肥厚患者中，观察到作为左心室一部分的肥厚室间隔，预计这些间隔电力会增加，类似于这些受试者的总左心室（QRS）电力。与这种预期相反，几项研究记录了符合左心室肥厚标准的患者心电图中正常方向的初始电力实际下降或消失。为了阐明这一矛盾的本质，启动了本研究。我们的观察结果表明，在最初的四到六年中，正常的初始间隔电力确实如预期那样增加，随后在左心室肥厚患者中逐渐下降。尽管在总QRS电力恒定期间间隔电力双峰变化的确切机制尚不清楚，但基于现有知识提出了一个假设来解释这些观察结果。
