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A study of 61 patients with congenital stenosis of the aortic ostium has shown that left ventricular myocardial dysfunction is related to the extent of myocardial hypertrophy. Progressive discrepancy between growing left ventricular myocardial hypertrophy and its blood supply resulted, at a certain point, in a qualitative change from compensatory to abnormal hypertrophy. The extent of left ventricular hypertrophy determined the severity of aortic stenosis and left ventricular dysfunction. The emergence of electrocardiographic signs of left ventricular hypertrophy and systolic overstrain is indicative of the defect acquiring a new quality--that of left ventricular and relative coronary insufficiency.
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