Nesje O A
Acta Med Scand. 1978;204(4):321-30. doi: 10.1111/j.0954-6820.1978.tb08447.x.
The external carotid pulse, the PCG, and the ECG were studied in 26 adult patients with valvular aortic stenosis whose systolic peak pressure gradients ranged from 18 to 165 mmHg. A significant correlation was found between the rapidity of the pulse upstroke, as measured by the T-time, and the location of the peak of the systolic murmur during ventricular ejection, on the one hand, and the gradient, on the other. The left ventricular ejection time (LVET) related directly and the pre-ejection period (PEP) indirectly with the gradient. There was a signficant inverse relationship between the PEP/LVET quotient and the pressure gradient but this quotient did not classify the patients according to the severity of the stenosis as well as the T-time and the location of the peak of murmur. When a combination of the T-time, the PEP/LVET, and the location of the peak of the murmur was used in each patient, a good discrimination between the patients was achieved. When the pressure gradient was above 50 mmHg, at lease one of the measurements was abnormal and when it exceeded 100 mmHg, at least two measurements were abnormal. The study further showed that it is possible to separate patients with valvular aortic stenosis from those with hypertrophic obstructive cardiomyopathy lidiopathic hypertrophic subaortic stenosis) or mitral insufficiency on the basis of carotid pulse tracings and PCGs.
对26例收缩期峰值压力阶差在18至165mmHg之间的成人瓣膜性主动脉狭窄患者的颈外动脉搏动、心音图（PCG）和心电图（ECG）进行了研究。一方面，通过T时间测量的脉搏上升速度与心室射血期收缩期杂音峰值的位置之间，另一方面与压力阶差之间，发现存在显著相关性。左心室射血时间（LVET）与压力阶差直接相关，射血前期（PEP）与压力阶差间接相关。PEP/LVET商数与压力阶差之间存在显著的负相关，但该商数对患者狭窄严重程度的分类不如T时间和杂音峰值位置。当对每位患者使用T时间、PEP/LVET和杂音峰值位置的组合时，能够很好地区分患者。当压力阶差高于50mmHg时，至少有一项测量值异常；当压力阶差超过100mmHg时，至少有两项测量值异常。该研究进一步表明，根据颈动脉搏动描记图和心音图，有可能将瓣膜性主动脉狭窄患者与肥厚性梗阻性心肌病（特发性肥厚性主动脉瓣下狭窄）或二尖瓣关闭不全患者区分开来。
