The resting cardiokymogram: Distribution of morphologies in normal patients and in patients with coronary heart disease

Abstract

Summary:The cardiokymograph, a relatively new noninvasive device capable of recording anterior left ventricular segmental wall motion, was used to evaluate the frequency and type of wall motion abnormalities in 25 normal patients and in 109 patients with ischemic heart disease. Of the 25 patients with normal coronary arteries and normal left ventriculograms, 24 had smooth systolic inward motion which morphologically resembles the normal pattern of systolic shortening as measured in experimental animals by various length gauges. In patients with angiographically established coronary artery disease but normal left ventriculograms and no previous myocardial infarction (MI), systolic outward motion was significantly more common than in normal patients. The most common systolic outward motion pattern seen in this group was partial outward motion characteristic of early stages of myocardial ischemia in experimental animals. In contrast, holosystolic outward motion, characteristic of severe ischemia in animals, was seen most commonly in patients with MI (72% anterior vs. 28% inferior). Thus, holosystolic outward motion was characteristic of MI especially when acute and involving the anterior wall, while partial systolic outward motion was the more common pat- tern in ischemic heart disease without MI, and systolic inward motion was the pattern most commonly seen in normals.

Noninvasive Diagnosis of Coronary Artery Disease: A Comparison between Cardiokymographic and Electrocardiographic Stress Testing

“…Criteria for the performance and interpretation of the CKG are empirically based, and quantitative criteria allowing an automatic CKG interpretation have yet to be defined. False-positive findings may be due to several different factors [10, 24, 25]including inadvertent recording over the cardiac apex which often reveals outward systolic motion not readily distinguishable from the holosystolic outward motion associated with severe ischemia [10, 24]. Motion changes especially of the inferior and posterior left ventricular wall as a consequence of an isolated stenosis of the right coronary artery may be the cause of false-negative findings [10, 17, 25].…”

Analysis of multiple noninvasive test procedures for the diagnosis of coronary artery disease

“…Other potentially applicable procedures designed to detect other specific and presumably independent markers of CAD are also available. Among these are cardiokymography for analysis of regional wall motion abnormalities (Diamond et al, 1978;Gay et al, 1976;Silverberg et al, 1980;Tzivoni et al. 1980;Vas et al.…”