The precordial acceleration tracing in hypertensive patients
Rosa, L.M.; Constantino, J.P.; Reich, R.
American Journal of Cardiology 9: 26-31
ISSN/ISBN: 0002-9149 PMID: 14493789 DOI: 10.1016/0002-9149(62)90094-2
Precordial acceleration tracings of 120 hypertensive patients were analyzed. Incidence and timing of abnormal patterns within the cardiac cycle were studied in correlation with blood pressure, electrocardiogram and clinical findings. The incidence of an abnormal pattern was significantly higher (nearly 10 times) than in a previous series of nonhypertensive, noncardiac patients. The precentage of abnormal phases sharply increased in patients with a diastolic blood pressure over 100 mm Hg and with electrocardiographic evidence of left ventricular "strain." The percentage rose when arterial hypertension was associated with chronic heart failure, malignant hypertension or pheochromocytoma. The various pulsatory abnormalities were interpreted on the basis of previous animal experiments. The degree of the disturbance was expressed by the number of pulsatory abnormalities within one cardiac cycle. Grade 0 (no abnormality) labeled normal tracings; grade 1 applied to borderline tracings; grade 2 meant definite disturbance of the pulsatory mechanism. The majority of tracings in patients with noncomplicated essential or arterio-sclerotic hypertension was classified as grade 2. The clinical significance of the pulsatory disturbance was related to the timing of the abnormality. Abnormalities in end systole and early diastole occurred in patients with clinically serious diseases. The precordial tracing is a sensitive indicator of hemodynamic and probably contractile disturbances. The study of the tracing offers a simple and practical way to detect, at an early stage, the presence and extent of the circulatory disturbance caused by arterial hypertension.