Manolas J, Rutishauser W, Wirz P, Arbenz U
Br Heart J. 1975 Dec;37(12):1263-7. doi: 10.1136/hrt.37.12.1263.
In 10 patients without left heart valvular disease and having normal function of the left ventricle, the left ventricular apex cardiogram with its first derivative (dA/dt), left ventricular pressure with its first derivative (dP/dt), aortic pressure, electrocardiogram, and phonocardiogram were reocrded simultaneously during cardiac catheterization. The apex cardiographic tracings were obtained by means of a transducer with infinite time constant and very high resonant frequency and the LV and aortic pressures with catheter tip-manometers. The onset of the systolic rise of apex cardiographic and LV pressures were found to occur almost simultaneously with the upstroke of LV pressure, preceding that of the apex cardiogram by only 2 +/- 4 ms (mean +/- 1 SD). The summit of the systolic upstroke of the apex cardiogram (called E-point) occurred 37 +/- 9 ms after opening of the aortic valve and 41 +/- 9 ms after peak dP/dt. The peak of dA/dt preceded peak dP/dt by 10 +/- 4 ms. The protodiastolic nadir of the apex cardiogram (called-O-point) occurred slightly earlier (19 +/- 16 ms) than the nadir of the LV pressure curve, with considerable variation. In conclusion, this study using external and internal transducers with similar characteristics gives a new definition of the time relation between the externally recorded apex cardiogram and the haemodynamic events within the left heart in human subjects with normal left ventricular function.
在10例无左心瓣膜病且左心室功能正常的患者中，在心脏导管检查期间同时记录了左心室心尖心电图及其一阶导数（dA/dt）、左心室压力及其一阶导数（dP/dt）、主动脉压力、心电图和心音图。心尖心电图描记图通过具有无限时间常数和非常高共振频率的换能器获得，左心室和主动脉压力通过导管尖端压力计获得。发现心尖心电图和左心室压力的收缩期上升起始几乎与左心室压力的上升同时发生，仅比心尖心电图提前2±4毫秒（平均值±1标准差）。心尖心电图收缩期上升的顶点（称为E点）在主动脉瓣开放后37±9毫秒出现，在dP/dt峰值后41±9毫秒出现。dA/dt的峰值比dP/dt的峰值提前10±4毫秒。心尖心电图舒张前期最低点（称为-O点）比左心室压力曲线最低点出现得稍早（19±16毫秒），且变化较大。总之，本研究使用具有相似特性的外部和内部换能器，对左心室功能正常的人体受试者外部记录的心尖心电图与左心内血流动力学事件之间的时间关系给出了新的定义。
