Vokrouhlický L
Katedra patologické fyziologie.
Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove Suppl. 1990;33(3):221-323.
The importance of noninvasive methods in cardiology has continuously been increasing; beside electrocardiography, phonocardiology, bicycle ergometry, echocardiography, radioisotopic examination and nuclear magnetic resonance, mechanocardiography preserves its significance, too. There are several reasons for it: modern apparatus technique has brought a pronounced increase in examination accuracy, comparison with invasive methods showed a number of mechanocardiographic data to be of value for left ventricular function evaluation, mechanocardiography is especially useful in repeated and long-term functional observation of the left ventricle, evaluation of treatment effects, revealing the onset of left ventricular dysfunction, the method is relatively economical and applicable even in peripheral workplaces. The literature survey of the study sums up the present knowledge of mechanocardiographic techniques, the genesis of curves and the manner of their evaluation, the physiological and other influences on the mechanocardiographic data and their clinical utilization. An analysis of experience gathered in a number of laboratories all over the world demonstrates the need of further improvement and development of the method. The present dissertation is aimed at this goal. I has set itself a task to contribute to the solution of some methodological problems of mechanocardiography and to evaluate critically its importance for the clinical practice. Polygraphy and apexcardiography (including 1st derivatives of curves) performed both at rest and during isometric handgrip exercise were used. From the obtained curves a wide spectrum of parameters was determined and several indices were calculated, some of them being introduced originally. The mechanocardiographic data were correlated in some studies with the results of echocardiography and bicycle ergometry and with invasive examination (heart catheterization, coronarography). The following results were obtained in the research into mechanocardiographic methodology problems: the suitability of a LPA 100 transducer of Czechoslovak production (Tesla VUST) was demonstrated; some physiological influences on the obtained values were determined (effects of age, respiration, body weight). The author's own method of cardiac cycle intervals correction to comparable values at unified cycle duration was elaborated; the effects of isometric handgrip exercise were studied in detail. The work was focused on verifying the importance of mechanocardiography for clinical cardiology. Therefore the method was used in a number of diseases and pathological conditions to get more complex experience. On the basis of the results obtained the value of mechanocardiography application in coronary artery disease has been demonstrated. The method provides a certain possibility in CAD diagnosis by means of combined evaluation of three sensitive parameters (pulse transmission time and two parameters of alpha wave amplitude). This type of valuation has been proposed by our laboratory.(ABSTRACT TRUNCATED AT 400 WORDS)
非侵入性方法在心脏病学中的重要性一直在不断提高;除了心电图、心音图、自行车测力计、超声心动图、放射性同位素检查和核磁共振外,机械心动图也保持着其重要性。原因有几个:现代仪器技术使检查准确性有了显著提高,与侵入性方法相比,一些机械心动图数据对评估左心室功能具有价值,机械心动图在对左心室进行反复和长期功能观察、评估治疗效果、发现左心室功能障碍的发作方面特别有用,该方法相对经济,甚至在基层工作场所也适用。该研究的文献综述总结了机械心动图技术的现有知识、曲线的产生及其评估方式、对机械心动图数据的生理和其他影响及其临床应用。对世界各地一些实验室积累的经验进行分析表明,该方法需要进一步改进和发展。本论文旨在实现这一目标。作者给自己设定了一项任务,即致力于解决机械心动图的一些方法学问题,并批判性地评估其对临床实践的重要性。使用了在静息和等长握力运动期间进行的多导记录和心尖心动图(包括曲线的一阶导数)。从获得的曲线中确定了广泛的参数并计算了几个指标,其中一些是首次提出的。在一些研究中,将机械心动图数据与超声心动图和自行车测力计的结果以及侵入性检查(心导管检查、冠状动脉造影)的结果进行了关联。在对机械心动图方法学问题的研究中获得了以下结果:证明了捷克斯洛伐克生产的LPA 100传感器(特斯拉VUST)的适用性;确定了对获得值的一些生理影响(年龄、呼吸、体重的影响);阐述了作者自己的将心动周期间隔校正为统一周期持续时间下可比值的方法;详细研究了等长握力运动的影响。这项工作的重点是验证机械心动图对临床心脏病学的重要性。因此,该方法被用于多种疾病和病理状况,以获得更丰富的经验。根据获得的结果,证明了机械心动图在冠状动脉疾病中的应用价值。该方法通过综合评估三个敏感参数(脉搏传播时间和α波振幅的两个参数)为冠心病诊断提供了一定的可能性。这种评估类型是由我们实验室提出的。(摘要截取自400字)