肺結核症における心機能判定法としての心音図学的研究

抄録

Phonocardiographic studies were carried out in 102 patients with pulmonary tuberculosis. In order to know the relations between the second heart sound and the pulmonary circulation, right heart sound and the pulmonary circulation, right heart catheterization was performed in 37 cases.
The results obtained were summerized as follows :
The grade of interval in split second heart sound had direct proportion to the stroke volume and inversed proportion to the pulmonary pressure and the total pulmonary vascular resistance.
In the other hand, ratio of the relative amplitude of the two components in the split second heart sound at the pulmonary area showed that pulmonary component was higher than aortic component when the pulmonary pressure and the total pulmonary vascular resistance increased. But they showed scanty to of phonccardiogroms as reflected cardiovascular hemodynamics. becouse the relative amplitude of the second heart sound skemed to be altered by various factors, i. e. rotation of the heart, locations and extents of the f ccus, cavity and adhesion.
The abnormal systolic murmurs were observed mostly on patients with left sided thoracoplastics.
Two types were divided by differences of cycle range of the systolic murmurs. First was“pure”type, second was“distorted”type.
It was thought to be due to differences of resonance by vortex with vascular wall or surrounding tissue upon the vascular system.
One case showed diastolic murmur, but its cause was unable to clear.
The split first heart sound was physiological phenomena, therefore have no pathological significance of pulmonary tuberculosis.
The relation between the pulmonary function and the second heart sound scarecely correlates.