Remodeling of the left ventricle: geometrical and electrocardiographic comparisons
In 129 patients with hypertensive disease1-3 degrees in age from 18 to 84 years was studied the relation between geometric and electrophysiological remodelling of the left ventricular. Patients were made echocardiography and 12-lead ECG. Vector electrocardiogram was made with reconstruction method in 12-lead ECG. The hypertrophy of the left ventricle (HLV) was diagnosed on the basis of the conventional electrocardiographic signs, criteria of Sokolow-Lyon and Cornell, and also at increase in the module of the maximum vector in proper plane >1,8 MV. The geometrical model of left ventricle myocardial hypertrophy was determined by A. Ganau classification et al. (1992). The normal geometry of the left ventricle is revealed in 52 patients (40,3%), concentric remodeling - in 18 patients (14%), concentric hypertrophy - in 29 (22,5%), and eccentric hypertrophy - in 30 (23,3%) patients. Criteria of EKG-VEG the HLV is revealed in 60 (46,5%) patients, and in 69 patients (53,5%) HLV is not diagnosed. In patients with normal geometry on an electrocardiogram criteria, the HLV is revealed in 36,5% of patients, it isn't diagnosed in 63,5% of cases. At concentric remodeling at an electrocardiogram the HLV was defined in 50% of patients, at a concentric hypertrophy in 51,7% of cases, at an eccentric hypertrophy at 56,7% of patients.It is demonstrated that patients with a hypertensive disease electrocardiographic criteria of a hypertrophy of the left ventricle can arise without change of mass of a myocardium of the left ventricle and its geometrical characteristics.