This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by CHANDRARATNA, P. A.N. Articles by HODGES, M. Search for Related Content PubMed PubMed Citation Articles by CHANDRARATNA, P. A.N. Articles by HODGES, M.

(Circulation. 1973;47:493.)
© 1973 American Heart Association, Inc.

---

Electrocardiographic Evidence of Left Atrial Hypertension in Acute Myocardial Infarction

PREMINDRA A.N. CHANDRARATNA M.D., M.R.C.P.¹ MORRISON HODGES M.D.¹

¹ From the Myocardial Infarction Research Unit and the Cardiology Unit, Departments of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.

The relationship between mean left atrial pressure (LA_m) and P-wave abnormalities in lead V₁ of standard 12-lead electrocardiograms was evaluated in 30 patients with acute myocardial infarction. In each patient pulmonary artery diastolic pressure or pulmonary wedge pressure was measured, and these values were used as an estimate of LA_m. Electrocardiograms recorded at the time of the pressure measurements were used for P-wave analysis. Patients with a history of hypertension were excluded from analysis. There was a significant correlation between the magnitude of the P terminal force in lead V₁ (PTF-V₁) and the estimated LA_m (r = –0.78, P < 0.001). Sixteen patients had a normal PTF-V₁ on admission; 11 of them had a normal LA_m. All 14 patients with an abnormal PTF-V₁ (more negative than –0.03 mm-sec) on admission had an elevated LA_m (>12 mm Hg). Thus, in 25 of the 30 patients, the PTF-V₁ correctly identified whether the LA_m was normal or abnormal on admission. On subsequent days, simultaneous measurements of PTF-V₁ and estimated LA_m were made in 27 of the patients. Significant changes occurred in both PTF-V₁ and LA_m; discordant changes were observed on only seven of 56 occasions. Measurement of PTF-V₁ appears to be a useful and reliable estimate of left ventricular filling pressure in patients with acute myocardial infarction.

Key Words: Electrocardiography • Indirect index of cardiac function

Submitted on October 3, 1972
Accepted on November 22, 1972

This article has been cited by other articles:

				M. Turkmen, I. Barutcu, A. M. Esen, O. Karakaya, O. Esen, and Y. Basaran Effect of Slow Coronary Flow on P-Wave Duration and Dispersion Angiology, September 1, 2007; 58(4): 408 - 412. [Abstract] [PDF]

				F. Ozmen, E. Atalar, K. Aytemir, N. Ozer, T. Acil, K. Ovunc, S. Aksoyek, and S. Kes Effect of balloon-induced acute ischaemia on P wave dispersion during percutaneous transluminal coronary angioplasty Europace, January 1, 2001; 3(4): 299 - 303. [Abstract] [PDF]

				K. Ishikawa and A. Yanagisawa Influence of an Upward Shift in the V1 Electrode Position on the P-Terminal Force Angiology, July 1, 1981; 32(7): 485 - 488. [Abstract] [PDF]

				N. CRISTAL, J. SZWARCBERG (SHAHAR), and M. GUERON Supraventricular Arrhythmias in Acute Myocardial Infarction: Prognostic Importance of Clinical Setting; Mechanism of Production Ann Intern Med, January 1, 1975; 82(1): 35 - 39. [Abstract] [PDF]