Nesje O A, Enge I
Acta Med Scand. 1977;202(3):197-202. doi: 10.1111/j.0954-6820.1977.tb16812.x.
External carotid pulse tracings were examined in 15 patients with hypertrophic obstructive cardiomyopathy (HOCM), the diagnosis being confirmed by catheterization of the left heart. Of 12 patients with intraventricular gradients at rest, 9 had a typical bifid pulse with midsystolic dipping. In one patient without a gradient at rest, midsystolic dipping occurred only in beats following extrasystoles (Brockenbrough phenomenon). The upstroke of the pulse wave was rapid in all the patients, a finding that distinguishes them from patients with valvular aortic stenosis. There was a correlation between the length of the left ventricular ejection time and the intraventricular gradient (r = 0.71) but as more than half the patients had normal or shortened ejection times, the diagnosis of HOCM cannot be based on measurements of this parameter. It is concluded that carotid pulse registrations are of considerable diagnostic value in patients suspected of having HOCM. As the pulse changes are correlated to the degree of left ventricular outflow obstruction, it is suggested that repeated pulse tracings may be used as a means for controlling the degree of obstruction once the diagnosis has been established in the individual patient.
对15例肥厚性梗阻性心肌病（HOCM）患者的颈外动脉脉搏描记图进行了检查，左心导管检查证实了诊断。在12例静息时存在心室内压差的患者中，9例有典型的双峰脉搏，伴有收缩中期下倾。在1例静息时无心室内压差的患者中，收缩中期下倾仅出现在早搏后的搏动中（布罗肯布罗现象）。所有患者的脉搏波上升支均迅速，这一发现将他们与瓣膜性主动脉狭窄患者区分开来。左心室射血时间与心室内压差之间存在相关性（r = 0.71），但由于超过一半的患者射血时间正常或缩短，因此不能基于该参数的测量来诊断HOCM。结论是，颈动脉脉搏记录对疑似患有HOCM的患者具有相当大的诊断价值。由于脉搏变化与左心室流出道梗阻程度相关，因此建议一旦在个体患者中确立诊断，重复的脉搏描记图可作为控制梗阻程度的一种手段。
