Bineau P, Granatelli D, Boschat J, Blanc J J, Penther P
Arch Mal Coeur Vaiss. 1983 Aug;76(8):934-42.
Good correlations have been reported between angiographic ejection fraction and indices of left ventricular function obtained by external polygraphic recordings. We studied 104 coronary or normal patients undergoing angiography within 24 hours of external polygraphic recordings. The angiographic ejection fraction was compared with three external indices in each case: the Weissler index (PEP/ET), the normalised derivation of a calibrated apex cardiogram (ds/dt/s) and the ejection fraction calculated from the apex cardiogram (EF apex). The angiographic ejection fraction was calculated after measuring left ventricular end diastolic and end systolic volumes in the 30 degrees RAO projection by a method derived from Dodge's. No correlation was found between the angiographic ejection fraction and any of the external indices. Analysis of our results and of those previously reported lead us to the following conclusions: --systolic time intervals are very sensitive to stress, imposing recording conditions which are difficult to meet in hospital surroundings, --a good quality apex cardiogram can only be obtained in a small percentage of patients, --the apex cardiogram reflects a mechanical phenomenon due to displacement of the apex beat and cannot therefore be assimilated to changes in cardiac volume, --the ds/dt/s index is difficult to calculate without a sophisticated computer. Therefore, these methods of external recording are not suitable for routine medical practice.
血管造影射血分数与通过外部多导记录获得的左心室功能指标之间已有良好相关性的报道。我们研究了104例在进行外部多导记录后24小时内接受血管造影的冠心病患者或正常患者。将血管造影射血分数与每个病例的三个外部指标进行比较：魏斯勒指数（PEP/ET）、校准心尖心电图的标准化导数（ds/dt/s）以及从心尖心电图计算得出的射血分数（EF心尖）。血管造影射血分数是通过一种源自道奇方法，在30度右前斜位投影下测量左心室舒张末期和收缩末期容积后计算得出的。未发现血管造影射血分数与任何外部指标之间存在相关性。对我们的结果以及先前报道结果的分析使我们得出以下结论：——收缩期时间间期对应激非常敏感，使得在医院环境中难以满足记录条件，——只有一小部分患者能够获得高质量的心尖心电图，——心尖心电图反映的是由于心尖搏动移位引起的机械现象，因此不能等同于心脏容积的变化，——如果没有精密的计算机，ds/dt/s指数很难计算。因此，这些外部记录方法不适用于常规医疗实践。
