[Left posterior fascicular block, isolated or associated with right branch block. Electro-vectorcardiographic aspects].
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Biomedical subjects
Publications and source records attributed to N Drăgulescu.
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The authors made a quantitative and qualitative vectorcardiographic analysis (Frank lead system) in 47 patients with hypertensive heart disease compared with a control group of 16 normal subjects. The magnitude and the angle of the maximum QRS vector, the sense of rotation of the QRS loop, the magnitude of the maximum posterior deflection (Sz), of the anterior maximum one (Rz), of the maximum leftward one (Rx), and of the maximum rightward one (Qx), the length (L) and the width W) of the QRS loop, as well as the angle of the maximum T vector were measured. A significant difference, in all planes of the maximum QRS magnitude between the normals and the AHT was found, while the maximum QRS angle was not significantly different. The quantitative analysis of the veg made in the horizontal plane revealed significant differences for the Sz, Rx, L, and the relation Rz/Sz. The quantitative analysis made according to Varriale et al. (1966) revealed a prevalence of the cases of type I A (72.3%) and I B (21.3%).
In our research we have aimed at studying the blood- and cerebrospinal fluid catecholamines' behaviour by means of von Euler-Floding's method, in a group of 30 patients, between 33 and 83 years, with chronic obstructive bronchopneumopathy, evolving from over ten years (even in younger persons). The total catecholamines in the cerebrospinal fluid have double values as against those in the blood, corresponding to the proportion found in a group of healthy subjects. On the contrary, the catecholamine fractions, occurring both in the blood and in the cerebrospinal fluid, have a diffent behaviour as against the normals, the adrenaline percentage exceeding by far the value of 23% recorded by these latter, going up to 46.95% in the blood and up to 47.68 in the cerebrospinal fluid. The increase of the adrenaline percentage may represent a pathogenetical factor, added to the other metabolic and hemodynamic factors, in the genesis of the chronic cardiopneumopathy; and the noxious effect acting on the whole myocardium supports the thesis according to which, earlier or later, in chronic obstructive bronchopneumopathy the left ventricle starts to suffer, as an integrant part of the clinico-morphological image.
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The electric stimulation of the lateral ventricular walls carried out in experiments on dog heart (open-thorax), as well as the analysis of the clinical, radiological and electrocardiographic data recorded in 462 cases with QRS macrovoltage led to the following conclusions: a) in 22% of the cases (hospital cardiologic examinations) this anomaly cannot be accounted for either by age, blood pressure or cardiac hypertrophy; b) a temporarily perturbed development of the ventricular depolarization, i.e. a "jerky" depolarization, not stagnant enough to produce an intraventricular block, may generate great negativity and positivity myocardial masses responsible for the appearance of large dipoles, namely of the increased QRS voltage; c) the coincident ischemia and macrovoltage of the QRS major wave, as well as the subsequent evolution of incipient CHD in a series of patients point to the hypothesis according to which the regional myocardial ischemia may induce a QRS macrovoltage by means of the above mechanism.
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