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[Comparison of the indices of left ventricular pumping function, contractility, myocardial metabolism and the magnitude of the R wave on the ECG of ischemic heart disease patients].

Central hemodynamics, myocardial contractility and consumption of major energy substrates (lactate, glucose, non-esterified fatty acids, NEFA), as well as the total R wave amplitude from 12 standard leads were assessed in 20 patients with neurocirculatory dystonia (the control group) and 36 patients with chronic coronary disease. The changes in central hemodynamics and contractility were particularly marked in 12 of the more severe coronary cases with a raised total R wave amplitude. Myocardial energy supply in such patients is provided at the expense of NEFA. The mildest cases, whose total R wave amplitude was as low as that of the controls, showed unchanged left-ventricular contractility and normal hemodynamic response to the atrial stimulation test. Myocardial glucose and lactate extraction prevails in these patients. It is suggested that a relationship may exist between the pattern of myocardial energy metabolism and the amplitude of electrocardiographic R wave.