Smith D, Ishimitsu T, Craige E
J Cardiogr. 1985 Jun;15(2):507-12.
In 18 open chest canine experiments, the ability of the left ventricle to transmit a mechanical vibratory tone from base to apex has been studied. An artificial tone source of constant amplitude and frequency was applied to the base of the exposed left ventricle. A miniature vibration sensor was applied to the anterior epicardium near the ventricular apex. This permitted us to obtain a heart surface phonocardiogram, in order to detect the portion of the source vibration which was transmitted to the apex. In three of the dogs, the heart surface phonocardiogram from the apex was compared with simultaneous intraventricular phonocardiograms which showed the amplitude of the vibration which reached the intraventricular blood mass. It was found that the normal ventricle transmits the tone from base to apex almost exclusively during systole, when the ventricle is contracted and stiff. In marked contrast, the normally relaxed and soft ventricle fails almost completely to transmit the tone to the apex. In conditions of poor relaxation ability of the left ventricle due to global hypoxemia, manifested by a long "Time Constant T", an abnormal diastolic transmission of the tone to the apex occurred during early diastole. We have defined this abnormal early diastolic "crescendo-decrescendo" type of transmissibility as "Type 1". The Type 1 transmission is related to impaired relaxation of the ventricle and is a manifestation of one or more abnormal ventricular muscle properties, such as myocardial stiffness, viscosity and density. In conditions of left ventricular hemodynamic failure caused by global hypoxemia, a separate abnormal mid-to-late diastolic "crescendo" type of transmissibility was found, and is defined as "Type 2".(ABSTRACT TRUNCATED AT 250 WORDS)
在18例开胸犬实验中,研究了左心室将机械振动音从心底传至心尖的能力。将一个振幅和频率恒定的人工音源施加于暴露的左心室底部。一个微型振动传感器置于心室心尖附近的前壁心外膜上。这使我们能够获得心脏表面心音图,以检测传至心尖的源振动部分。在3只犬中,将心尖处的心脏表面心音图与同时记录的室内心音图进行比较,后者显示了到达心室内血液团块的振动幅度。发现正常心室几乎仅在收缩期(此时心室收缩且僵硬)将声音从心底传至心尖。与之形成鲜明对比的是,正常松弛且柔软的心室几乎完全无法将声音传至心尖。在因全身低氧血症导致左心室舒张能力不佳的情况下,表现为“时间常数T”延长,在舒张早期会出现声音向心尖的异常舒张期传导。我们将这种异常的舒张早期“渐强-渐弱”型传导性定义为“1型”。1型传导与心室舒张受损有关,是一种或多种心室肌异常特性的表现,如心肌僵硬度、黏度和密度。在因全身低氧血症导致左心室血液动力学衰竭的情况下,发现了一种单独的舒张中晚期“渐强”型异常传导性,并将其定义为“2型”。(摘要截短于250字)