Ratio of Total Amplitude to Diastolic Wave on the Apexcardiogram. Findings in Aortic Regurgitation and Other Cardiac Lesions

Utilizing the apexcardiogram, the ratio of total amplitude to the height of the total diastolic wave was determined. Compared with a mean (+/- 1 SD) value of 21 +/- 4% for normal subjects there were statistically significant differences in those patients with isolated aortic regurgitation (30 +/- 10%, P = 0.01), aortic stenosis (12 +/- 11%, P less than 0.025) and mitral insufficiency (14 +/- 8%, P less than 0.025). There were no significant changes of this ratio in subjects with combined aortic stenosis and insufficiency (24 +/- 9%, P less than 0.25), triple vessel coronary artery disease (19 +/- 7%, P less than 0.25) and mitral valve prolapse (23 +/- 10%, P less than 0.35). There was a trend for higher ratio values in patients with greater angiographic evidence of aortic insufficiency, but no correlation between the ratio and left ventricular end-diastolic pressure. These alterations of the apexcardiogram accord with hemodynamic findings in the presence of each respective lesion. It is concluded that this ratio is useful for the noninvasive assessment of isolated aortic regurgitation, aortic stenosis and mitral insufficiency.