[A clinical study with apexcardiogram, kinetocardiogram and carotid pulse tracing in aortic insufficiency (author's transl)].

The apexcardiogram, kinetocardiogram and carotid pulse tracing were studied in 24 normal subjects and 20 patients with aortic insufficiency. The electrocardiogram and phonocardiogram were recorded simultaneously as the time reference. The study of the carotid pulse tracing and systolic time intervals was made using the injection of methoxane and inhalation of amyl nitrite. In aortic insufficiency, the apexcardiogram of the infinite decay time tended to demonstrate a lift of end-systolic shoulder according to the severity of the disease, while, kinetocardiograms at K-45 showed a prominent systolic outward movement. The correlation ratio of these findings between normal and aortic insufficiency was 0.59 in the apexcardiogram and 0.72 in the kinetocardiogram. The findings were also correlated with CTR with a correlation coefficient of 0.41 and 0.62 in aortic insufficiency only or 0.63 and 0.81 including normal cases. The apexcardiogram of the short time constant represented no characteristic changes. Therefore, it might be concluded that the kinetocardiogram is more useful than the apexcardiogram in determining the existence and severity of aortic insufficiency. Effects of acute hemodynamics changes: the effects of increasing total peripheral resistance on the externally recorded carotid pulse were determined by the injection of methoxamine. This drug showed changes characterized by a rise in the ratio of the height of the tidal wave to that of the percussion wave. In contrast, amyl nitrite decreased total peripheral resistance and produced a significant decline in the ratio of the height of the tidal wave to that of the percussion wave. In conclusions, the carotid waves contain two systolic maximums, the percussion wave and tidal wave, the former related, at least in part, to peak blood volume and the latter to aortic pressure. Comparing with systolic time intervals in aortic insufficiency and that of normal cases, the patients with aortic insufficiency had statistically significant increase in the ejection time index and pre-ejection time, especially after the injection of methoxamine.