Kinetocardiogram (KCG) is considered to reflect the ventricular movement. Consequently, the usefulness of KCG as a noninvasive method for examining the ventricular movement was studied in 101 cases with myocardial infarction, 22 with congenital heart diseases, 67 with valvular diseases, 3 with idiopathic hypertrophic subaortic stenosis (IHSS), 3 with primary pulmonary hypertension (PPH), and 40 with hypertension.
In KCG, a normal systolic inward movement produces a downward deflection, while an abnormal systolic outward movement, such as a
bulge
seen in myocardial infarction, produces an upward deflection. Systolic bulges were present in 75% of acute myocardial infarction, and 52.8% of old infarction when recorded more than 1 month after the attack.
Left ventriculography (LVG) was carried out in 15 cases of myocardial infarction. Six patients showing bulges in KCG revealed dyskinesis, akinesis or hypokinesis in LVG. Four cases, in which LVG revealed dyskinesis or akinesis, showed bulges in KCG. Cases of infarction having bulges showed an increase in left ventricular end-diastolic volume and a decrease in ejection fraction.
In KCG recorded within 2 months after the attack, all 10 patients without bulges showed a favorable course. About half of the cases with 2 to 4 bulges had a favorable course, but the other half were suffering from post-infarction angina. Almost all the patients having more than 5 bulges died. The course was favorable in all patients without bulges or with only one
bulge
in KCG recorded more than 1 year after the attack, but most of the patients with more than 2 bulges were suffering from post-infarction angina, myocardial reinfarction, or congestive heart failure. Some of them died.
Systolic outward movements, i. e.
bulge
-like movements, were also seen in various other heart diseases; 36.4% of congenital heart diseases, 58.2% of valvular diseases, 33.2% of IHSS, 100% of PPH, and 47.5% of hypertension.
Bulge
-like movements were seen in all patients with mean pulmonary wedge pressure of more than 25 mmHg, who also showed right ventricular hypertrophy ECG pattern. Cardio-thoracic ratio in patients with
bulge
-like movements was significantly greater than those without them. Th e incidence of left ventricular hypertrophy ECG pattern was higher in patients with
bulge
-like movements than those without them.
It is concluded that KCG is useful to assess the clinical course and prognosis of myocardial infarction and to evaluate the pathophysiology of other heart diseases.
Bulge
-like movements can easily be differentiated from myocardial infarction by taking into consideration its location together with clinical signs and symptoms.
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