[Phono-mechano-cardiographic assessment in hypertensive heart disease: value of the apex cardiographic parameters (author's transl)].

In 15 normal subjects and in 19 patients with essential hypertension (NYHA I-II) systolic time intervals (STI) and diastolic more expressive parameters of the left ventricular performance were studied by phono-meccano-cardiography. ICT, LVET, ICT/LVET, iso-volumic relaxation period (A2-0) and rapid filling time (O-F) were measured. On the apexcardiogram relative height of rapid filling (RF) and atrial (A) waves measured too. "Diastolic index", a ratio between this two phenomena (hRFw/hAw) was calculated. Results were evaluated in relation with ECG, arterial pressure and subjective sympthoms. There were no statistically significant differences in mean values of the STI among normotensive and hypertensive subjects. On the contrary the parameters which explore into diastolic period result in disagreement and significantly influenced by diastolic arterial pressure. Comparison showed that patients in the hypertensive group had longer mean isovolumic relaxation period (P < 0.01), longer mean O-F time (P:ns), lower mean RF wave (P < 0,01) and higher mean atrial wave (P < 0,01). Consequently hRFw/hAw mean ratio was lower (P < 0,01) and frequently reversed. The lengthening of iso-volumic relaxation period and reduction of diastolic index were more consistent in the symtomatic patients (P:ns). It is concluded that poligraphic research, in patient with hypertensive heart disease, must not be restricted to the STI but it has to include a poliparametric evaluation of all phases of cardiac circle. The diastolic index may prove a simple, readily available and noninvasive guide in the assessment of left ventricular function.