[Mechanocardiography in modern cardiology]

The importance of noninvasive methods in cardiology has continuously been increasing; beside electrocardiography, phonocardiology, bicycle ergometry, echocardiography, radioisotopic examination and nuclear magnetic resonance, mechanocardiography preserves its significance, too. There are several reasons for it: modern apparatus technique has brought a pronounced increase in examination accuracy, comparison with invasive methods showed a number of mechanocardiographic data to be of value for left ventricular function evaluation, mechanocardiography is especially useful in repeated and long-term functional observation of the left ventricle, evaluation of treatment effects, revealing the onset of left ventricular dysfunction, the method is relatively economical and applicable even in peripheral workplaces. The literature survey of the study sums up the present knowledge of mechanocardiographic techniques, the genesis of curves and the manner of their evaluation, the physiological and other influences on the mechanocardiographic data and their clinical utilization. An analysis of experience gathered in a number of laboratories all over the world demonstrates the need of further improvement and development of the method. The present dissertation is aimed at this goal. I has set itself a task to contribute to the solution of some methodological problems of mechanocardiography and to evaluate critically its importance for the clinical practice. Polygraphy and apexcardiography (including 1st derivatives of curves) performed both at rest and during isometric handgrip exercise were used. From the obtained curves a wide spectrum of parameters was determined and several indices were calculated, some of them being introduced originally. The mechanocardiographic data were correlated in some studies with the results of echocardiography and bicycle ergometry and with invasive examination (heart catheterization, coronarography). The following results were obtained in the research into mechanocardiographic methodology problems: the suitability of a LPA 100 transducer of Czechoslovak production (Tesla VUST) was demonstrated; some physiological influences on the obtained values were determined (effects of age, respiration, body weight). The author's own method of cardiac cycle intervals correction to comparable values at unified cycle duration was elaborated; the effects of isometric handgrip exercise were studied in detail. The work was focused on verifying the importance of mechanocardiography for clinical cardiology. Therefore the method was used in a number of diseases and pathological conditions to get more complex experience. On the basis of the results obtained the value of mechanocardiography application in coronary artery disease has been demonstrated. The method provides a certain possibility in CAD diagnosis by means of combined evaluation of three sensitive parameters (pulse transmission time and two parameters of alpha wave amplitude). This type of valuation has been proposed by our laboratory.(ABSTRACT TRUNCATED AT 400 WORDS)