and their relation to concurrent aging changes. (P < 0.001) in the combined group (0.62 ± 0.18 cm), the right ventricular (RV) pressure overload group (0.60 ± 0.13 cm) and the RV volume overload group (0.53 ± 0.11 cm). Thirty-two patients underwent diagnostic right heart catheterization which revealed a good correlation between the RVWT measured echocardiographically and the right ventricular peak systolic pressure (r = 0.84).Subxiphoid echocardiography was considered to be useful in diagnosing right ventricular hypertrophy in adults.size of the right ventricle, the value of which increases in patients with atrial septal defect or tricuspid insufficiency.
SUMMARY M-mode and cross-sectional echocardiograms of 37 patients with complete left bundle-branch block were compared with those of 5 patients with complete atrioventricular block during right ventricular pacing, 20 patients with anteroseptal infarction, and 20 normal subjects.Of 37 patients with complete left bundle-branch block, 35 showed 3 types (A, B, and C) of abnormal septal motion and 2 patients showed normal septal motion. In type A and B, early and abrupt posteriorlydirected motion of the septum occurred during the pre-ejection period. After this early abnormal motion, the septum moved anteriorly in type A and posteriorly in type B. Type C exhibited akinetic or dyskinetic septal motion throughout systole. The onset of posterior wall contraction was delayed in all patients with complete left bundle-branch block.These patterns of abnormal septal motion were observed in almost all portions of upper-to mid-septum that could be recorded by cross-sectional echocardiography.Abnormal septal motion of types A and B was also observed during right ventricular pacing. It is suggested that abnormal septal motion of types A and B could be explained by asynchronous contraction of the left ventricle, with delayed activation of the left side of the septum and of the left ventricular free wall.The septal motion of type C is almost the same as that seen in patients with extensive septal infarction. Most of the patients having abnormal septal motion of type C had electrocardiographic and vectorcardiographic findings which were compatible with extensive septal infarction. Thus patients with complete left bundle-branch block and type C motion may have sufficient septal damage to prevent the early posterior motion seen in type A and B patients. Different sequence of ventricular activation will be responsible for the difference between type A and B. It is also possible that some patients with type A septal motion may have septal damage to some degree, in contrast to type B.Normal septal motion recorded in 2 patients with complete left bundle-branch block might be the result of a peripheral block of the left bundle-branch.M-mode and cross-sectional echocardiography have proved to be valuable in the study of left ventricular wall motion and the assessment of left ventricular function (Diamond et al., 1971;Jacobs et al., 1973, Fujii et al., 1976.Recently, echocardiography has disclosed a characteristic ventricular septal motion in patients with left bundle-branch block (McDonald, 1973;Dillon et al., 1974). It has been suggested that abnormal septal motion is related to an altered Received for publication 3 April 1979 sequence of activation and contraction. However, no studies have been performed to analyse the left ventricular wall motion in left bundle-branch block by cross-sectional echocardiography.The purpose of this study was (1) to analyse the motion of the interventricular septum and the left ventricular posterior wall in patients with complete left bundle-branch block by M-mode and crosssectional echocardiography; (2)...
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