Esophageal Phonocardiographic Studies on Atrial Sound
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概要
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On a total of 130 cases, including 36 normal cases and 94 cases of various diseases, consisting mainly of 36 cases of hypertension, esophageal phonocardiography (PCG) and precordial PCG were performed to observe normal and pathologic atrial sounds. At the same time, the relation to ECG findings, systemic blood pressure and pulmonary pressure obtained by right heart catheterization was observed. Then the rate of appearance of atrial sounds by esophageal PCG and precordial PCG and their nature were compared and reviewed and correlations to the severity were obtained. Also various loading tests were performed on the same cases of hypertension to review changes in atrial sounds. Atrial sounds recorded by esophageal PCG are generally larger in intensity than those recorded by precordial PCG and the rate of recording atrial sounds by the former method was 114 cases (88%) of all the 130 subjects, 30 cases (82%) of the 36 normal cases and 36 cases (100%) of the 36 cases of hypertension. On the other hand, atrial sounds were recorded by precordial PCG in 40% of all the subjects, 25% of the normal group and 58% of the hypertension group. Atrial sounds were frequently recorded by precordial PCG in cases of left ventricular hypertrophy and ST, T abnormalities on ECG. The rate of recording atrial sounds by precordial PCG was high in cases of hypertension and left ventricular hypertrophy, namely, cases with large left ventricular overloading. Further for such cases, there was a relative tendency of shortened P-IV interval on PCG as against P-R interval on ECG. These changes in P-IV interval were also noted in cold pressor test, Valsalva's test and amyl nitrite inhalation test performed on the same case of hypertension. It was presumed that atrial sounds (2nd component) were dependent upon left ventricular overloading. Pathologic atrial sounds recorded by esophageal PCG and precordial PCG were compared with atrial sounds of normal cases, which revealed that atrial sounds recorded by precordial PCG were considered to be atrial sounds which became large in intensity (or had pathologic elements) and were conveyed to the chest wall. However, there were some cases with more possibility of pathologic findings, which were recorded by esophageal PCG but not by precordial PCG. Even in these cases, differences of P-R : P-IV were large and from the aspect of timing, it is possible to some extent to predict latent heart insufficiency. In this meaning, the clinical value of esophageal PCG is very large.
- 社団法人日本循環器学会の論文
- 1970-09-20