左心室のシストリック解荷と冠内圧の増加と,強化された外部対衝動の間にドップラー流
Andrew D Michaels1, Michel Accad, Thomas A Ports
1Division of Cardiology, Department of Medicine, University of California at San Francisco Medical Center, San Francisco, Calif 94143-0124, USA. andrewm@itsa.ucsf.edu
Circulation
|September 5, 2002
まとめ
強化された外部対脈動 (EECP) は,大動脈と冠動脈の静脈圧を下げながら,大動脈と平均気圧を大幅に上昇させます. この非侵襲的療法により,冠動脈の流れが増加し,潜在的に機械的補助装置として作用します.
科学分野:
- 心臓病学 心臓病学
- 心血管生理学 心血管の生理学
- 医療機器 医療機器について
背景:
- 強化された外部対衝動 (Enhanced External Counterpulsation,EECP) は,慢性性 angina の患者に有益であることが知られている非侵襲的な肺療法です.
- EECPが血液動力学に及ぼす直接的な生理学的影響は,十分に研究されていない.
- この研究は,EECPが冠内動脈と左心室の血液動力学に与える影響を調査しています.
研究 の 目的:
- 冠動脈内におけるEECPの血液動力学的効果を直接評価する.
- EECP中の冠動脈内圧と流れ速度の変化を定量化するために.
- 機械支援装置としてのEECPの可能性を評価する.
主な方法:
- 診断用心臓キャセテリゼーションを受けた10人の患者を研究した.
- 冠内圧とドップラー流速は,特殊なガイドワイヤーを用いて測定した.
- EECPの適用中に中央大動脈圧もモニタリングされました.
主要な成果:
- EECPはダイアストリック (+93%) と平均 (+16%) の冠内圧を著しく増加させた.
- 静脈動脈内圧は,EECP中に15%低下しました.
- ドップラーとTIMIフレームカウントで測定された冠動脈の流れは,それぞれ109%と28%増加しました.
結論:
- EECPは,大動脈と冠動脈の静脈圧を下げながら,ダイアストリックと平均気圧を効果的に上昇させます.
- EECPでは,冠動脈の流れが著しく増加します.
- 収縮性下荷と改善された輸液圧の組み合わせは,EECPが機械的補助装置として機能することを示唆しています.
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