後期外収縮現象の心電曲線,ならびに,心力学的分析について
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概要
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The electrocardiograms of the cases complicated with premature beats, indifferently from the existence of the cardiac disorders, were investigated with special reference to the dynamics of the postextrasystolic phenomenon, and then the correlation between mechanical and electrical phenomenon was compared in order to examine the clinical significance of the postextrsystolic phenomenon. Statistically as to the premature beats here observed, there could not be found any difference of frequency between male and female. Most of patients were above 40 years of age. The seasonal occurrence of premature beats here examined, was most often seen in winter and easly spring. From the view point of the kinds of underlying diseases, premature beats were most commonly observed among arterial hypertension inclusive of hypertonic diseases, so that it could not necessarily be said that the greatest number of premature beats is seen in congestive heart failure; however on the whole, premature beats here discussed were found among cardiovascular disorders by an overwhelming majority. About the classification of the origins of premature beats the compensatory ventricular extrasystoles were most often observed, then the auricular, the interpolated ventricular and the atrioventricular premature beats were put in order. 1. In the connection of postextrasystolic phenomenon, the shortening of both PQ and QT ratio (Bazett) was usually seen, but in the interpolated ventricular premature beats both PQ and QT ratio were prolonged. As far ST-T, the depression was often found. U waves increased in their height in the first postextrasystolic normal beats, whereas they rather decreased in the second postextrasystolic. So far as this observation is concerned the changes upon P and QRS of postextrasystolic normal beats were relatively uncommon. 2. The myocardial damages did not always show the positive postextrasystolic phenomenon in like manner that the congestive heart failure was not necessarily accompanied with premature beats. It may be rather note-worthy that among the cases suffered from vegetative dystonia the postextrasystolic phenomenon including the elevation of ST segment were not rarely seen in the both the first and the second normal beats. The rheumatic diseases showed sometimes the prolonged PQ and the abnormally deformed T waves, The ventricular gradient remained usually within normal variation in the coronary disorders even complicated with the changes of QRS. 3. It is difficult to find out any direct correlation between the changes of cardiodynamical values and the occurrence of postextrasystolic phenomenon, however in the cases with the volume response (Blumberger), PQ was often shortened and in cases with the pressure response (Blumberger) T wave was used to be abnormally deformed. The dynamics of the preextrasystolic basic beat does not necessarily differ from that of the other basic beat. In the preextrasystolic basic beat with dynamics different from that of the other basic beat, "Anspnnungszeit" may be able to be either prolonged or shortened; consequenty the integrative conclusion is not so easily to be drawn as Baschieri et al have emphasized. The first poextrasystolic beat has usually the large stroke volume enough to dynamically compensate the decreased stroke volume of premature beat, showing the shortened "Anspannungszeit". The first postextrasystolic heart beat without shortedened "Anspannungszeit" can, as a rule, be considered as dynamically decompensated first postextrasystolic beat implies in itself the possibility to newly initiate an extrasysteole.
- 千葉大学の論文