Analysis of neurocirculatory asthenia by means of psychological tests and hemodynamic parameters

The borderline between neurocirculatory asthenia (NCA) and its allied diseases is not always clear. To stady this problem, variours hemodynamic parameters, respiratory curves and psychological tests such as Cornell Medical Index (CMI) and Yatabe-Gilford test (Y-G) were analyzed in 83 cases having NCA-like complaints without organic heart disease.The CMI was normal in 35 and abnormal in 48 patients. The Y-G test was normal in 71 and abnormal in 12 patients.Arterial blood pre s s ure, cardiac index (CI) and total peripheral resistence (TPR) in supine position were not different from the patients with normal to abnormal CMI, while mean brachial arterial pressure (mBP) and CI were higher in the patients with abnormal Y-G than normal, although values of both groups were within normal range.Immediately after standing, the group with normal CMI showed significantly higher TPR than that with abnormal CMI, and the normal Y-G group showed a lower changing ratio of mBP and a higher changing ratio of TPR at standing and a smaller CI after standing, each showing a statistically significant difference.Cardiothoracic ratio (CTR) was 45.8±3.6% in abnormal 41.2±3.5% in normal CMI cases, which was significantly smaller than in abnormal cases (p<0.01). Similarly a significant difference was observed between normal and abnormal Y-G groups (p<0.05).Lowering of TII at standing was observed most frequently in group I of CMI. There were statistically significant difference between group I and each of group III and IV.A significant negative correlation (r=-0.475, p<0.01) was found be t w een CTR and lowering of TII.The patients with normal respiratory curve were more frequent in normal CMI group, while those with abnormal curve more frequent in abnormal group, showing a significant difference between two groups (p<0.01). A similar relationship was found also in Y-G test.A significant positive correlation was observed also between CTR and respiration curve: as the heart smaller, the fewer were the abnormal finding in respiration curve.Furthermore, in 32 of 35 caces with normal psychological tests, abnor m alities were found in anyone of the hemodynamic parameters.Absence of significant corre l ation between T. lowering at standing and abnormal respiration curve may explained by the concept that these two phenomena are caused by different mechanism.In 35 cases with normal psychological tests, 12 cases showed CTR smaller than 40% and 25 cases smaller than 43%. This indicates the small heart itself is a possible cause of circuratory distress.