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The apexcardiogram in myocardial asynergy.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Lane, F. J. Carroll, John M. Levine, Harold D. Gorlin, Richard |
| Copyright Year | 1968 |
| Abstract | SUMMARY The apexcardiogram was analyzed in 41 patients with an altered pattern of left ven-tricular contraction. Four types were distinguished: type I, an early sustained systolic bulge which occurred in 12 patients, all of whom had large aneurysms and large end-diastolic volumes; type II, a bulge confined to midsystole which occurred in 13 patients, 11 of whom had some form of ventricular asynergy; type III, a late or end-systolic bulge which occurred in 12 patients, seven of whom had ventricular asynergy; type IV, a prominent spike during diastolic filling which occurred in four patients who had large zones of ventricular asynergy. THE NORMAL apexcardiogram and its temporal relationship to electrical, acous-tical, and mechanical cardiac events has been the subject of previous communications from various laboratories,1 2 including our own.3 The normal pattern is uniform, reproducible, and clearly correlated with known hemody-namic events. Lack of general agreement about the gene-sis of the apexcardiogram and technical difficulties in recording it have discouraged a more general use. The low frequency vibrations , which result from relative movement in the chest wall beneath the cup applicator, are thought to result from actual movement of the heart and great vessels, from changes in volume and velocity of movement of the heart, and from changes in the consistency and curvature of the heart wall.4' 5 Particular difficulty arises in attempting to evaluate systolic events from the apexcardiogram. and chamber geometry might be expected to induce changes in the systolic configuration of the apexcardiogram. Vakil6 described three types of abnormal pulsations in patients with acute myocardial infarction. By means of the kinetocardiogram, Harrison, Eddleman, and co-workers7-11 described a systolic bulge of the heart wall in acute myocardial infarc-tion and in angina pectoris. Isometric contraction has been shown to be prolonged not only in patients with ischemic heart disease1l-'3 but also in normal elderly individuals .'4 This report concerns the apexcardiogram in patients with coronary artery disease who had disturbances of left ventricular contraction as detected by cine ventriculography. We hope to show that systolic and diastolic components of the apexcardiogram are indeed related to mechanical events in contraction of the left ventricle and that certain recorded patterns are characteristic of specific abnormalities of contraction. Methods Forty-one patients were analyzed in whom angiography demonstrated coronary artery disease and myocardial asynergy. Seven of these had apical systolic murmurs and angiographically demonstrated mitral insufficiency. |
| Starting Page | 39 |
| Ending Page | 44 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/37/6/890.full.pdf |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/37/6/890.full.pdf?download=true |
| PubMed reference number | 5653052v1 |
| Volume Number | 37 |
| Issue Number | 6 |
| Journal | Circulation |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Aneurysm Angina Pectoris Arteriopathic disease Blood Vessel Cardiac ventriculography Cardiac wall structure Cardiomyopathies Chest wall structure Cine Procedure Congenital Abnormality Coronary Artery Disease Diastole Heart Ventricle Kidney Failure, Chronic Left ventricular structure Mitral Valve Insufficiency Myocardial Infarction Myocardial Ischemia Myocardium Patients Ventricular Fibrillation Ventricular Remodeling Vibration - physical agent angiogram |
| Content Type | Text |
| Resource Type | Article |
