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[Chronometric cardiovascular examination. A clinical method to determine the duration of various circulatory
Insights
This study introduces a chronometric clinical exploration method, combining electrocardiograms with physical exam phenomena to measure cardiac intervals. The technique demonstrates good correlation with phonography, proving effective for diagnosing cardiac conditions.
Area of Science:
- Cardiology
- Clinical Physiology
- Biomedical Engineering
Context:
- Traditional cardiac diagnostics rely on separate auscultation and electrocardiography.
- Accurate timing of cardiac events is crucial for diagnosing various cardiopathies and arteriopathies.
- Existing methods may lack precision in correlating subtle physical phenomena with electrical cardiac activity.
Purpose:
- To introduce and validate a novel
- chronometric clinical exploration
- method for precise cardiac interval measurement.
- To assess the correlation between the new method's measurements and established phonocardiographic/apicographic values.
- To evaluate the method's efficacy in classifying systolic murmurs and identifying specific cardiac sounds.
Summary:
- A chronometric clinical exploration was performed on 127 patients (cardiopathy, arteriopathy, normal).
- This method integrates electrocardiogram (ECG) timing with physical phenomena, measuring intervals like acoustic systole and systolic murmur duration.
- High correlation coefficients (0.58-0.83) were found when comparing the new method with phonography, with 91.0% accuracy in classifying systolic murmurs.
Impact:
- Provides a more integrated and potentially more accurate approach to cardiac timing than separate ECG and auscultation.
- Offers a validated tool for improved diagnosis and classification of cardiac conditions, including murmurs and specific heart sounds.
- Enhances clinical decision-making by offering precise temporal data correlating physical signs with electrical activity.
Abstract:
In 127 cases (70 with cardiopathy, 41 with arteriopathy and 16 normals) a "chronomethryc clinical exploration" was performed. This procedure consists in obtaining an electrocardiogram at the same time a clinical examination is performed and in the very moment of the occurrence of a physical or oscilometric phenomenon the standardization marker of the electrocardiogram is actioned to register a mark indicating a Q-phenomenon interval. 3 of this intervals are measured for each clinical phenomenon and the two closest values are averaged. This method is based in the fact that the time of human reaction varies relatively little when 2 successive similar phenomena are appreciated (for ej.: 0.158 sec. +/- 0.036 (SD) and 0.154 sec. +/- 0.042 (SD), n = 32, P = non significant for the first and 2nd. auscultated cardiac sounds). In this way the following intervals were estimated: acustyc systole (n = 52), 2nd. sound-opening mitral snap interval (n = 17), duration of systolic cardiac murmur (n = 22), mechanic systole (n = 14), left ventricular eyection time (n = 15), and IIa-O interval (n = 17) and compared with their respectives phonographyc or apicography values with correlations coefficients of 0.58, 0.83, 0.73, 0.58, 0.70, and 0.70, respectively. The sistolic murmurs were classified in proto, meso or telesystolic and a good correlation was found with the phonography (method in 91.0% of cases). This procedure also identified correctly a left IV sound (n = 8) even in cases in which this sign formed a complex with the first heart sound.