Isometric Contraction Period of the Left Ventricle in Acute Myocardial Infarction

Abstract

The usefulness of nontraumatic methods for measuring the left ventricular isometric contraction period (ICP) in myocardial infarction (MI) has been evaluated. The ICP was measured in 13 normal men and 38 patients admitted to a coronary care unit with chest pain, including 18 with acute MI, 12 with old MI, and nine with chest pain of miscellaneous origin; one of these nine was also included in the group with acute myocardial infarction. ICP was determined by three different methods: (1) time between the onset of systolic wave (A) of apexcardiogram (ACG) and the beginning of upstroke (C) of carotid pulse tracing (CPT); (2) time between A and ejection crest (E) of the ACG; and (3) time between the initial low frequency, low amplitude vibration of the first heart sound, and the C of CPT. Statistically significant differences of ICP between the normal group and the three groups of patients were demonstrated only by method 1. Likewise, acute coronary ligation in seven dogs produced characteristic changes in ICP by method 1, which were associated with a reduction in the left ventricular (LV) stroke volume, LV dp/dt, and the aortic flow velocity. The ICP obtained by method 1 appears to be of value in the bedside evaluation of acute myocardial infarction.