Edgren made experiments on the temporal relation of the wave _f_ and
of the dicrotic wave, which to avoid misunderstandings he calls the
"wave _f_´." His experiments were made as follows. A sphygmogram from
the carotid and a cardiogram were taken simultaneously, the points
of the writing-levers being in the same vertical line. The wave _f_´
appeared a little after the wave _f_. The length of this interval
could be calculated by measuring the distance between these waves, as
the speed of the drum was known. From this was subtracted the time
of propagation of the dicrotic from the heart to the point where the
instrument was fixed. In this way it was found that the time between
the appearance of the wave _f_ and of the wave _f_´ was equal to
the time of propagation of the dicrotic wave from the heart. Edgren
concluded that the dicrotic wave is in close temporal relation to the
closure of the valves.[76] To this comes the supposition that the wave
_f_´ is due to a change of pressure proceeding from the heart. The wave
_f_´, therefore, could be attributed to the tension of the valves.[77]
Edgren and Tigerstedt are the chief exponents of this theory.
In so far as this theory assumes that the dicrotic elevation is due
to a wave travelling from the heart to the periphery,[78] it is
open to all the arguments against a theory of the central origin
of the dicrotic wave. Against the more special assertion that the
dicrotic elevation is in connection with the closure of the valves,
the following facts must be mentioned. We grant that the tracings
of the apex beat may be directly substituted for the curves of
intraventricular pressure, although this is by no means obvious, since
one tracing gives the form of the pressure changes and the other the
effect of the shock of the heart against the wall of the chest. It is,
furthermore, not proved that the wave _f_ is due to the closure of the
valves and that the waves _f_ and _f_´ correspond to each other so
closely as Edgren's experiments seem to indicate. His measurements of
the length of lines were made with an exactitude of 0.1 mm., but his
computations were carried to the third decimal place of a second. The
third decimal is generally inexact and the second in a large number of
cases. Experimental evidence, furthermore, directly contradicts the
statement that the dicrotic elevation corresponds to the wave _f_.
Fredericq[79] traced pressure curves in the ventricle and in the aorta,
and determined the points of equal pressure in both curves. He thus
found that a point near the beginning of the descent of the curve of
intraventricular pressure corresponds to the dicrotic. His experiments
are rather conclusive against the theory in question, since the wave
_f_ is very well marked in these tracings of Fredericq. The following
facts, however, are fatal for the theory that the closure of the valves
causes the dicrotic elevation: The dicrotic wave disappears in diseases
Public-domain text, read in full here on John Shaqi.
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