[Electrocardiographic changes in chronic obstructive lung diseases].

Abstract

Various patterns and frequency of electrocardiographic changes in patients with chronic obstructive lung disease (COLD), as well as their relationship to the degrees of air-flow obstruction, were investigated. Electrocardiograms and pulmonary function tests were analysed in 302 patients (230 men and 72 women) with COLD, and the results were compared with the results of the same examinations obtained in 86 healthy subjects (63 men and 23 women). The most common electrocardiographic patterns were: a) "P pulmonale", b) right axis' deviation of the P wave, and right axis' deviation of the QRS complex, c) inversion of the T waves in standard (II and III) and in the precordial leads (V1 to V4), d) the presence of a qR pattern with delayed R wave in V1 (V5R) (onset of intrinsicoid deflection more than 0,003 seconds) which was often associated with an incomplete right bundle branch block.--P pulmonale and inversion of the T waves in standard and precordial leads were considered as labile, reversible electrocardiographic changes which do not show any correlation with the severity of COLD. Deviations of the P wave and QRS complex to the right, significantly correlated with the degree of the air-flow obstruction (P less than 0,05) in patients with COLD, but the changes are not sure signs of chronic cor pulmonale. On the contrary, qR pattern with delayed R wave in V1 (V5R) (onset of intrinsicoid deflection more than 0,03 seconds), which was often associated with an incomplete right bundle branch block, was significantly correlated (P less than 0,001) with the degree of air-flow obstruction in patients with COLD and may be considered as highly suggestive for the diagnosis of chronic cor pulmonale.