P wave terminal force and persisting ST elevations in chronic ischemic heart disease. Prediciton of left ventricular motility and diastolic pressure.

In 80 male patients with coronary heart disease P terminal force in V (V Ptf) was correlated with left ventricular end-diastolic pressure (LVEDP) and the findings by left ventricular angiography (ejection fraction (EF) and signs of aneurysm). The correlation between V Ptf and LVEDP was statistically significant (r= - 0.56, n= 80, p less than 0.001). Abnormal V Ptf ( less than -0.03 mm. second) used to detect LVEDP greater than 12 mm. Hg gave sensitivity 59 per cent (22 of 37) and specificity 88 per cent (5 of 43 false positive). The mean V Ptf in 26 patients with aneurysm and/or EF Less than 50 per cent (dyskinesia group) was -0.058 mm. second in contrast to -0.021 in patients with EF greater than 50 per cent (p less than 0.001). Abnormal V Ptf was a more sensitive parameter in separating the dyskinesia group from the others than abnormal ST elevations (sensitivity 73 vs. 54 per cent, respectively); but less specific (83 vs. 98 per cent). In this respect the specificity of V Ptf increases inversely proportionally to the V Ptf value. Both of these electrocardiographic parameters may be useful in the primary selection of patients suited for surgical treatment of coronary heart disease.