抄録
In 71 patients with myocardial infarction (MI), abnormalities of left ventricular wall motion (LVWM) were studied by kinetocardiogram (KCG), apex cardiogram (ApCG) and left ventriculogram (LVG). The results of three different methods were compared with each other to evaluate the utility of the former two as a non-invasive method.In addition, relationships of KCG and ApCG to left ventricular function (LVF) were studied.
Patients were classified by KCG into systolic bulge (SB) cases, atypical cases and normal cases, by ApCG into type I (distinctly abnormal cases), type II (less abnormal cases) and type III (normal cases), and by LVG into distinctly abnormal cases showing dyskinesis or akinesis and less abnormal cases showing hypokinesis or normal.
SB on KCG were observed in 49.3%, type I ApCG in 62%, and distinctly abnormal LVG in 62.3%.Twenty-eight of 33 cases (84.8%) with SB on KCG showed distinctly abnormal LVG and eleven of 13 (84.6%) with normal KCG showed less abnormal LVG.There was a close relationship between the site of abnormal LVWM evaluated by KCG and those by LVG. Thirty of 42 cases (71.496) with type I ApCG showed distinctly abnormal LVG and nine of 14 (64.3%) with type X ApCG showed less abnormal LVG.SB on KCG was observed in 65.1% and type I ApCG in 73.2% of cases showing distinctly abnormal LVG, while SB on KCG was observed in 19.2% and type I ApCG in 50% of cases showing less abnormal LVG. Incidence of false positive cases was much more lower in KCG than ApCG.Cases with SB on KCG showed significantly lower ejection fraction (EF)(p<0.01), larger left ventricular end-diastolic volume (LVEDV)(p<0.05), higher left ventricular end-diastolic pressure (p<0.05) and largex cardiothoratic ratio (CTR)(p<0.01) than other cases.In addition, the number of leads showing SB on KCG had a significant correlation to EF (p<0.05), LVEDV (p<0.01) and pre-ejection period/left ventricular ejection time (p<0.001).Cases with type I ApCG showed lower EF <0.05), larger LVEDV (p<0.05) and larger CTR (p<0.05) than other cases.
It is concluded that KCG and ApCG are useful non-invasive methods to evaluate not only LVWM, but also LVF in patients with MI.KCG seems superior to ApCG because of lowei incidence of false positive cases and more LVF indices which were significantly correlated tc KCG.
