Authors evaluated the electrocardiographic criteria of Minnesota Code (III-1, III-2) for the diagnosis of left and right ventricular hypertrophy in 93 cases of healthy peoples, 74 cases of left ventricular hypertrophy and 4 cases of right ventricular hypertrophy and following results were obtained. 1. By left ventricular hypertropy criteria (III-1), there were 5.4% of false positive and 14.9% of false negative cases. 2. By right ventricular hypertrophy criteria III-2), there were 24.7% of false positive and 20.0% of false negative cases. 3. Electrocardiographic diagnosis of ventricular hypertrophy by Minnesota Code (III-1, III-2) were more reliable criteria than many other criteria of ventricular hypertrophy.
Diagnosis* ; Electrocardiography ; Hypertrophy* ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Minnesota*

Hypertrophic cardiomyopathy (HCM) has diverse pathophysiological and clinical features, according to the extent and severity of the hypertrophy development. Hypertrophy mostly involves the left ventricle and sometimes causes a left ventricular outflow tract obstruction. Right ventricular involvement is less frequent, and even the severe form of a right ventricular outflow tract (RVOT) obstruction by concurrent right ventricular hypertrophy in a patient with HCM is rare. We report a case of biventricular HCM with a clinically, morphologically, and hemodynamically significant RVOT obstruction, which had been treated successfully with surgical myectomy.
Cardiomyopathy, Hypertrophic ; Heart Ventricles ; Humans ; Hypertrophy ; Hypertrophy, Right Ventricular

During a period of 5 years and 3 months, from January, 1980 to march, 1985, 42 cases of ventricular septal defects were observed to be closed spontaneously during their follow up period and were evaluated at pediatric department, hanyang University hospital. 1) Sex incidence shows female preponderance with male to female ration of 1:2. 2) The mean age when they were diagnosed as ventricular septal defect was 5.0+/-6.4 months, and that of VSD murmur last noted was 13.3+/-11.5 months. The mean age when typical VSD murmur disappeared due to spontaneous closure of the defects was 21.1+/-18.7 months. Spontaneous closure of ventricular septal defects disclosed under one year in 22 cases (52.4%). Of those 22 cases, ventricular septal defects were spontaneously closed under 6 months of age in 16 cases(38.8% of whole study population). From the whole study population 90.5%(38 cases) were spontaneously closed under the age of 5 years. 3) Major clinical and physical characteristics before spontaneous closure of ventricular septal defects were typical pansystolic murmur with maximum intensity at left lower sternal border in all cases, palpable thrill in 5 cases(12.8%), ventricular heaves in 4 cases(10.2%) and frequent respiratory infection histories in 27 cases(64.3%). 4) Electrocardiographic findings when they were initially presented as ventricular septal defects revealed normal axis in 28 cases(84.8%), left axis deviation in 3 cases(9.1%), right axis deviation in 2 cases(6.1%) as frontal QRS axis and left ventricular hypertrophy in 8 cases(24.2%), right ventricular hypertrophy in 5 cases(15.6%) and biventricular hypertrophy in 3 cases(8.7%). Other electrocardiographic abnormalities when they had ventricular septal defects were left atrial enlargement in 12 cases(36.4%) and intraventricular conduction delay in 12 cases(36.4%). After spontaneous closure of ventricular septal defects, the electrocardiographic findings revealed normal axis in 36 cases(92.3%), left axis deviation in 3 cases(7.7%) and left ventricular hypertrophy in one case(2.6%). The remaining abnormalities after spontaneous closure of ventricular septal defect were intraventricular conduction delay in 14 cases(35.9%), deep SV6 in 4 cases(10.3%), tall RV6 in 5 cases(12.8%) and long QTc in 1 case(2.6%). Thirty-eight cases(97.4%) do not show ventricular hypertrophy pattern in EKG after spontaneous closure of their defects. 5) When we analyse their frontal plain chest X-ray films after spontaneous closure of ventricular septal defects, cardiomegaly(cardiothoracic ratio)55%) noted in 7 cases(17.9%) and pulmonary plethora in 5 cases(12.8%);while those before the defect were closed spontaneously were 67.6% and 64.7%, respectively. 6) Among 26 cases who underwent follow up 2 dimensional echocardiographic study so-called septal aneurysm were noted with the process of spontaneous closure of ventricular septal defects in 15 cases(57.7%) and the remaining 11 cases do not have any evidence of 'septal aneurysm' even after the completion of spontaneous closure of their defects. In the patient group with so-called 'septal aneurysm' the proportion of female sex was 60% and early systolic clicky sound were heard in 9 patients from 15 cases(60.0%), while those without 'septal aneurysm'were 55% and 18.2%, respectively.
Aneurysm ; Axis, Cervical Vertebra ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Thorax ; X-Ray Film

Mass electrocardiographic (ECG) examination was performed on 13,801 children (male 7,526 and female 6,275) of elementary and middle school in Taegu from May 1. 1986. to April 30. 1987. We read their ECG according to the “pediatric Electrocardiography”1) The results were as following: The incidence of ECG abnormality was 1.05% (male 1.3% and female 0.75%). Fifty eight children (0.42%) had atrial and ventricular hypertrophy; two right atrial hypertrophy, five left atrial hypertrophy, thirty five right ventricular hypertrophy and sixteen left ventricular hypertrophy respectively. Ectopic beats occurred in 25 children (0.18%); They were atrial in 12 children, ventricular in 8 children and junctional in 5 children. There were 62 children (0.45%) of conduction disturbance; They were first degree atrioventricular (A-V) block in 21 children, type I second degree A-V block in 1 child, A-V dissociation in 1 child, right, right bundle branch block in 36 children, left bundle branch block in 1 child and WPW syndrome in 2 children. Nonspecific ST, T changes and sinus tachycardia were found in 3 and one children respectively.
Bundle-Branch Block ; Child* ; Daegu ; Electrocardiography* ; Female ; Heart Block ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Tachycardia, Sinus ; Wolff-Parkinson-White Syndrome

BACKGROUND: Pulmonary hypertension is a poor prognostic factor in patients with chronic respiratory disease. However, diagnosing pulmonary hypertension is a difficult procedure which often requires an invasive test. Thus new alternative biochemical markers would be useful in clinical field and are in search. We sought to assess the role of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with pulmonary hypertension. METHOD: We measured plasma NT-proBNP level in twenty nine patients suspected for pulmonary hypertension. Pulmonary hypertension was defined as being right ventricular systolic pressure more than 35 mm Hg estimated by Doppler echocardiography. Plasma NT-proBNP level was measured by electrochemiluminescence sandwich immunoassay. RESULTS: The log-transformed values for plasma NT-proBNP levels showed a linear correlation (correlation coefficiency: 0.783, p-value <0.001) with right ventricular systolic pressure. Plasma NT-proBNP levels closely correlated with right ventricular systolic pressure, right ventricular hypertrophy, interventricular septal flattening and right ventricular dilatation. CONCLUSION: Our results suggest that the measurement of plasma NT-proBNP level is an useful marker of the presence of pulmonary hypertension.
Biomarkers ; Blood Pressure ; Diagnosis* ; Dilatation ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension, Pulmonary* ; Hypertrophy, Right Ventricular ; Immunoassay ; Plasma*

The electrocadiographic and vectorcardiographic findings were reviewed in 49 cases of tetralogy of Fallot, confirmed by cardiac catheterization and angiocardiographic findings and/or, by surgery. In most cases, the electrocardiographic findings were right axis deviation and right ventricular hypertrophy. Vectorcardiographic findings were as following; 1) The initial vector directed to anterior and slightly left or right. 2) The maximum vector directed to right, anterior or posterior and inferior. 3) The terminalvector directed to right, posterior and inferior. 4) The loop inscription of horizontal plane and frontal plane were mainly clockwise. Five cases out of 49 showed somewhat atypical electrocardiographic findimgs. In 2 cases, rS pattern all through the chest leads were observed and in another 2, right chest leads showed the RS pattern(predominantly S) and left chest leads showed the not tall R waves and in the remaining 1, left axis deviation was noticed. The vectorcardiogram of these 5 cases showed the less Rx and Qz, larger Sx and Rz. In horizontal plane, main area is shifted to the third quadrant and direction of the maximum vector is right, posterior and inferior, and the inscription of loop is counterclockwise or figure of 8. The vectorcardiographic findings of tetralogy of Fallot which showed rS pattern were not different from those of single ventricle which showed rS pattern all through the precordial leads. Counterclockqwise or figure of 8 herizontal inscription is known to suggest mild tetralogy of Fallot but counterclocwise or figure of 8 inscription with small Rz and Qz may suggest severe tetralogy of Fallot.
Axis, Cervical Vertebra ; Cardiac Catheterization ; Cardiac Catheters ; Electrocardiography* ; Hypertrophy, Right Ventricular ; Tetralogy of Fallot* ; Thorax

The pathophysiological implications of aldosterone and adrenomedullin in the cardiac ventricular hypertrophy were examined. Male Sprague-Dawley rats were treated with deoxycorticosterone acetate (DOCA)-salt and monocrotaline (MCT) to selectively elicit left and right ventricular (LV, RV) hypertrophy, respectively. The mRNA expression of aldosterone synthase and adrenomedullin in LV and RV was determined by reverse transcription-polymerase chain reaction. The expression of aldosterone synthase and adrenomedullin was increased in LV, while not altered significantly in RV of DOCA-salt-treated rats. On the contrary, the expression was not significantly altered in LV, but increased in RV of MCT-treated rats. The enhanced expression of aldosterone synthase may be causally related with the development of ventricular hypertrophy, and the increased expression of adrenomedullin may act as a counter-regulatory mechanism.
Adrenomedullin* ; Aldosterone Synthase* ; Aldosterone* ; Animals ; Desoxycorticosterone ; Humans ; Hypertrophy ; Hypertrophy, Right Ventricular* ; Male ; Monocrotaline ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger

The present study was aimed to explore pathophysiological implications of nitric oxide in the development of left and right ventricular hypertrophy. To induce selective left and right ventricular hypertrophy, rats were made two-kidney, one clip (2K1C) hypertensive and treated with monocrotaline (MCT), respectively. Six weeks later, the hearts were taken and their ventricular tissue mRNA and protein expression of endothelial constitutive isoform of nitric oxide synthase (NOS) were determined by reverse transcription-polymerase chain reaction and Western blot analysis, respectively. In 2K1C hypertensive rats, the expression of NOS mRNA was increased in parallel with its proteins in the left ventricle, but not in the right ventricle. In MCT-treated rats, the expression of NOS mRNA and proteins were proportionally increased in the right ventricle, but not in the left ventricle. These results suggest that the expression of NOS is specifically increased in association with the ventricular hypertrophy, which may be a mechanism counteracting the hypertrophy.
Animals ; Blotting, Western ; Cardiomegaly ; Heart ; Heart Ventricles ; Hypertrophy ; Hypertrophy, Right Ventricular* ; Monocrotaline ; Nitric Oxide Synthase ; Nitric Oxide* ; Rats ; RNA, Messenger

The cardiomyopathies constitute a group of diseases in which the dominant feature is direct involvement of the heart muscle itself. They are distinctive because they are not the result of pericardial, hypertensive, congenital, valvular, or ischemic diseases. Although the diagnosis of cardiomyopathy requires the exclusion of these etiological factors, the features of cardiomyopathy are often sufficiently distinctive-both clinically and hemodynamically-to allow a definitive diagnosis to be made. With increasing awareness of this condition, along with improvements in diagnostic techniques, cardiomyopathy is being recognized as a significant cause of morbidity and mortality. Whether the result of improved recognition or of other factors, the incidence and prevalence of cardiomyopathy appear to be increasing. A variety of schemes have been proposed for classifying the cardiomyopathies. The most widely recognized classification is that promulgated jointly by the World Health Organization (WHO) and the International Society and Federation of Cardiology (ISFC). In the WHO/ISFC classification, the cardiomyopathies are classified based on their predominant pathophysiological features; other diseases that affect the myocardium that are associated with a specific cardiac disorder or are part of a generalized systemic disorder are termed specific cardiomyopathies. Three basic types of functional impairment have been described: 1) dilated (DCM, formerly called congestive), the most common form, accounting for 60 percent of all cardiomyopathies and characterized by ventricular dilatation, contractile dysfunction, and often symptoms of congestive heart failure; 2) hypertrophic (HCM), recognized by inappropriate left ventricular hypertrophy, often with asymmetrical involvement of the interventricular septum, with preserved or enhanced contractile function until late in the course; and 3) restrictive (RCM), the least common form in western countries, marked by impaired diastolic filling and in some cases with endocardial scarring of the ventricle. Two other forms of cardiomyopathy are recognized: arrhythmogenic right ventricular cardiomyopathy and unclassified; the latter includes fibroelastosis, systolic dysfunction with minimal dilatation, and mitochondrial involvement. The distinction between the three major functional categories is not absolute, and often there is overlap; in particular, patients with HCM also have increased wall stiffness as a consequence of the myocardial hypertrophy and thus present some of the features of an RCM. Late in their course, ventricular dilation and systolic heart failure, bearing some resemblance to DCM, may occur. The aim of this review is to introduce the unusual forms of cardiomyopathy with the current literatures in this field.
Arrhythmogenic Right Ventricular Dysplasia ; Cardiology ; Cardiomyopathies* ; Cicatrix ; Classification ; Diagnosis ; Dilatation ; Heart Failure ; Heart Failure, Systolic ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Incidence ; Mortality ; Myocardium ; Prevalence ; World Health Organization

Animals ; Drugs, Chinese Herbal ; pharmacology ; Hypertrophy, Left Ventricular ; pathology ; Hypertrophy, Right Ventricular ; pathology ; Models, Animal ; Myocardium ; pathology ; Organ Size ; drug effects