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慢性的な大動脈吐:大動脈弁置換が左心室の体積,質量,機能に及ぼす影響

W H Gaasch, C W Andrias, H J Levine

|November 1, 1978

まとめ

大動脈弁置換 (AVR) は,慢性大動脈吐症 (AR) の患者で,左心室 (LV) の体積と質量を成功裏に減少させます. 半径と壁の厚さの比率は,外科手術後のLVリモデルの管理に役立つ結果を予測します.

科学分野:

心臓病学心臓病学
心臓外科手術について
エコーカルディオグラフィーエコーカルディオグラフィー

背景:

慢性的な大動脈反発 (AR) は,左心房 (LV) の膨張と機能障害につながる.
大動脈弁置換 (AVR) は,重度のARに対する標準的な治療法です.
AVRがLVの改造に与える影響を理解することは,患者の管理に不可欠です.

研究の目的:

慢性AR患者のAVR後のLV体積,質量,機能の連続変化を評価する.
成功した手術結果を予測するエコーカルジオグラフィのパラメータを特定する.
LVの末期ダイアストリック半径と壁の厚さ (R/Th) の比率の予後値を評価する.

主な方法:

19人の患者でAVR前後の連続エコーカルディオグラフィー試験を実施した.
LVの寸法,壁の厚さ,および派生筋量 (横断面積) を分析した.
R/Th比を計算し,臨床結果と相関させました.

主要な成果:

成功したAVRは,半年以内に,LVのエンド・ダイアストリック次元を大幅に減らし,LVの質量を正常化しました.
静脈収縮機能は,後期以降に改善する傾向を示した.
術前のR/Th比>=4は,AVR後のサブ最適のLV寸法縮小を有する差別化された患者でした.

結論:

成功したAVRは,慢性ARにおいて,LVの容量を正常化し,LVの質量を減少させます.
術前R/Th比は,AVR後のLVリフォームの貴重な予後指標です.
この比率は,選択されたAR患者における分数縮小とは無関係な洞察を提供することができる.

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