The apical impulse in coronary heart disease

Area of Science:

• Cardiology
• Diagnostic Imaging
• Physiology

Background:

• Left ventricular dysfunction is a key indicator of cardiovascular disease.
• Assessing left ventricular function non-invasively is crucial for patient management.
• Apexcardiography offers a potential method for evaluating left ventricular mechanics.

Purpose of the Study:

• To define apexcardiographic parameters reflecting left ventricular (LV) function changes.
• To correlate these parameters with clinical assessment of the apical impulse.
• To establish the utility of apexcardiography in coronary artery disease (CAD).

Main Methods:

• Studied 40 patients (36 with CAD) using standardized apexcardiography.
• Correlated apexcardiogram findings with angiographically assessed left ventricular function.
• Identified abnormalities based on measurements from patients with normal LV function.

Main Results:

• Increased percent A wave amplitude alone did not indicate significant LV dysfunction.
• Isolated isovolumic slope abnormalities suggested mild LV dysfunction, often undetectable clinically.
• Moderate to severe LV dysfunction consistently showed abnormal ejection phase slopes and sustained apical impulses.

Conclusions:

• Left ventricular function significantly impacts apical impulse characteristics in CAD patients.
• Apexcardiography parameters, particularly ejection phase slopes, effectively indicate LV dysfunction.
• Specific apexcardiographic findings can be easily defined and correlated with clinical status.