Echocardiographic Analysis of Anterior Mitral Valve Motion and its Relationship with the Terminal Force of the P Wave in Lead V₁ in Ischemic Heart Disease

Echocardiographic study was designed to evaluate the slopes and amplitudes of anterior mitral valve motion (anterior mitral valve echogram, AMVE) in 100 patients (pts) with Ischemic Heart Disease (IHD). The results were compared with those of 53 normal subjects. Soon after the Echocardiographic study, the P terminal force (PTF) was determined from the P wave in lead V1 and the calculated PTF was attempted to correlate with each velocity of the AMVE. Sudjects and Methods; 23 pts with Myocardial Infarction (MI) (3 recent and 20 remote), 8 pts with angina Pectoris (AP) and 69 pts without the symptom of Ischemic Cardiac Pain (ICP), whose ages ranged from 43 to 81 years (yrs) with a mean age of 61 yrs underwent echocardiographic study. Criteria for diagnosis of pts without the symptom of ICP were as follows: 1) diminution of amplitude of the T wave (T/QRS ratio of less then 10%) 2) ischemic S-T segment depression 1.0mm or greater 3) a depression of S-T segment greater than 0.5mm at the point of 0.04 second after the J junction. Those who satisfied the Master's criteria of Master's single two-step test were also included in the group, if the above mentioned criteria were not satisfied. 18 chronic hypertensive subjects under good control with salt restriction and antihypertensive drugs were included in the group and neither those with valvular heart disease nor those with cardiomyopathy were included. Those with papillary muscle dysfunction syndrome were not included in the pts with AP or MI and those with clinical ecidence of congestive heart failure were excluded from the pts without the symptom of ICP. Finally, subjects who had any signs or X-ray evidence suggestive of chronic obstructive pulmonary disease were excluded from the study. Electrocardiograms showed normal sinus rhythm with no P-R prolongation.