高血圧症の心音図学的研究 第1編 高血圧症の心音図

PCG and ECG were studied in 118 cases of the hypertensive with maximum blood pressure more than 150 mmHg or minimum blood pressure more than 90 mmHg. Fifty two cases of the health were chosen as control. The following results were obtained. 1) Duration of the first sound was 0.073±0.017 sec in the hypertensive and 0.067±0.019 sec in the health. So much maximum or minimum blood pressure rose, duration of the first sound prolonged. 2) In the hypertensive, although it is not so-called Hegglin's syndrome, an actually measured QⅡ interval was shortened and an actually measured QT interval was prolonged. As a result, QⅡ/QT ratio became small coresponding with elevation of maximum or minimum blood pressure and with deterioration of electrocardiographic sign. From the point of view to separate mechanical work from electoric action of the heart, therefore, it is possible to estimate the functional state of the heart. 3) Protodiastolic gallop sound (accentuation of the third heart sound) was recorded in the hypertensive more often than in the health. That was recorded more often at the Erb's area than at the apex in the hypertensive, and in the health, more often at the apex than at the Erb's area. From the above, together with correlation of electrocardiographic sign, it was thought that the protodiastolic gallop sound was participated in dysfunction of atrioventricular valve due to left ventricular myocardial failure. 4) Frequency of the protodiastolic gallop sound was recorded highly in the cases with ST. T change and the LVH plus ST. T change. This fact was regarded as increase of the relative diastolic overloading. 5) Frequency of the apical systolic murmur was 83% in the hypertensive and 53% in the health. Those murmurs were all plateau or diamond shape ejection murmur. Therefore, the hypertensive cardiac failure might not be caused by relative mitral insufficiency, but by myocardial ischemic change. Degree of the hypertensive and cardiac function of the hypertensive were inferable with this study.