2002, Number 1
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Arch Cardiol Mex 2002; 72 (1)
Reflexive arterial waves
Sánchez TG, Infante VO, Martínez MR, Flores CP, Rodríguez RG
Language: Spanish
References: 20
Page: 29-35
PDF size: 95.23 Kb.
ABSTRACT
Antecedent: Through sphygmokynetocardiography (SKCG) an exploratory method that records an electrocardiographic signal, a carotid pulse (CP), and two vibriograms (kinetocardiograms) of the left ventricle (LV) recorded in the left hemithorax (anterior kinetocardiogram, AKC) and the subcostal region of left abdomen (posterior kinetocardiogram of PKC, vibrations transmitted through the hemidiaphragm) we observed a systolic precocious reflection wave (Rw) in the CP and prolongation of LV ejection time (LVET) measured in AKC or in PKC of the previous sinusal pre-extrasystolic beat (PEB) vs control beats (CB) in cases with ventricular extrasystoles (VEs).
Objective: To demonstrate whether the intervals just mentioned are associated with ventricular extrasystoles.
Method: Sixty cases: 30 with VEs, group A, and 30 without arrhythmia, group B, were studied through SKCG. The LVET and the arterial reflection index or ARI = Ta-rw/LEVT, Ta-rw = time between initial ventricular impulse to reflexive wave, were measured.
Results: Demography was similar in both groups. PEB had a longer LVET than the CB (291 ± 41 vs 279 ± 39, p ‹ 0.01) and ARI was shorter (0.36 ± 0.17 vs 0.58 ± 0.21, p ‹ 0.001).
Conclusions: 1) Distention of the LV due to Rw, possibly through the well-known experimental mechanism of electromechanic feedback, is believed to underlie the arrhythmia. 2) The observation has important clinical implications.
REFERENCES
Infante O, Rodríguez G, Pérez J, Espinosa L, Valenzuela F: Terminal electrocardiográfica. Rev Mex Ing Biomed 1988; 9: 87-95.
Infante O, Sánchez G, Martínez R, Chávez P, Sánchez G: Sistema para la medición no invasiva de la velocidad del pulso arterial. Arch Inst Cardiol Mex 1999; 69: 330-337.
Sánchez G, Infante O, Martínez R, Sánchez G, Flores P: Provocación y medición de 1a velocidad de la onda pulsátil retrógrada en sujetos normales e hipertensos. Arch Ins Cardiol Mex 1999; 69: 47-54.
Taggart P, Sutton PMI: Cardiac mechano-electric feedback in man: clinical revelance-progress in biophysic. Molecular Biology 1999; 71: 139-154.
Reiter MJ: Contraction-excitation feedback. In: Zippes DP, Jalife J: Cardiac Electrophysiology. From cell to bedside, 3th, London, Toronto. Ed. Saunders Philadelphia Company, 2000: 249-255.
Lab MJ: Mechanically dependent changes in action potentials recorder from the intact frog ventricle. Circ Res 1978; 42: 519-528.
Taggart P: Mechano-electric feedback in the human heart. Cardiovasc Res 1996; 32: 3-43.
Sasaki N, Mitsuiwe T, Noma A: Effect of mechanical stretch on membranes currents on single ventricular myocites of guinea-pig hearts. Jpn J Phisiol 1992; 42: 957-970.
Wang Z, Taylor LK, Denney WD, Hansen DE: Initiation of ventricular extrasystoles by myocardial stretch in chronically dilated and failing canine left ventricle. Circulation 1994; 90: 2022-2031.
Taggart P, Sutton P, John R, Lab M, Swanton H: Monophasic action potential recordings during acute changes in ventricular loading induced by the Valsalva manoeuore. Br Heart J 1992; 67: 221-229.
Bashir-Sheddon JF, O’Llunain-Selal L: Comparative electrophysiological effects of captopril or hydralazine combined with nitrate in patients with left ventricular tachycardia. Br Heart J 1992; 67: 355-360.
Taggart P, Sutton P, Lab M, Runnals M, O’Brien, Treasure T: Effect of abrupt changes in ventricular loading on repolarization induced by transient aortic occlusion in human. Am J Physiol 1992; 263: H1816-H823.
Sánchez TG, Infante O, Martínez-Memije R, Flores P, Rodríguez G, Urrieta J, Sánchez-Miranda G: Sistema de registro de la velocidad de la onda del pulso con ayuda del quinetocardiograma anterolateral. Estudios en sujetos normales e hipertensos. 1er. Congreso Latinoamericano de Ingeniería Biomédica. Rev Mex Ing Biomed 1998; 1: 651-654.
Sánchez MG, Sánchez TG, Infante O, Martínez-Memije R, Flores P, Rodríguez G: Reflexión sistólica del pulso. Un índice de sobrecarga sistólica en la hipertensión arterial. Memorias del 6º. Congreso Nacional de la Sociedad de Hipertensión Arterial de México A.C. 1998. resumen 41.
Sánchez TG, Infante O: La mecánica en la patología cardiovascular. Arch Inst Cardiol Mex 1996; 66: 301-305.
O’Rourke M, Kelly RP: Wave reflection in the systemic circulation and its implications in ventricular function. J Hipertension 1993; 11: 327-337.
Berger DS, Robinson KA, Shroff SG: Wave propagation in copple left ventricle-arterial system implications for aortic pressure. Hypertension 1996; 27: 1079-1089.
Sharir T, Marmor A, Ting CT, Chen JW, Luic P, Chang MS: Validation of a method for noninvasive measurement of central arterial pressure. Hypertension 1993; 21: 74-87.
Hansen DE, Borganell M, Stacy G, Taylor LK: Dose-dependent inhibition of stretch-induce arrhythmia’s by gadolinium in isolated canine ventricles. Evidence for a unique mode of antiarrhytmic action. Cir Res 1997; 69: 820-831.
Janse MJ: The premature beat. Cardiovasc Res 1992; 26: 89-100.