ヒトのミトラス狭窄症における左心房の適合性の低下. リバーシブルな内部制約の役割
1Department of Internal Medicine, Johns Hopkins Medical Institutions, Baltimore, Md.
Circulation
|April 1, 1992
まとめ
側頭管狭窄症は,左心室の適合性を低下させることにより,静脈動脈機能を損なうが,静脈動脈機能は損なわない. バルーンバルブ整形手術は,ミトラル狭窄症の患者におけるこの立方体機能不全を効果的に逆転させます.
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
背景:
- 左心室 (LV) ポンプの性能に影響を与えるミトラ狭窄症 (MS) のメカニズムは不明である.
- MSの埋め込みが少ないことは,血液動力学的測定に影響を及ぼし,分析を複雑にします.
研究 の 目的:
- ヒトのミトラス狭窄症における圧力-体積関係を調査する.
- MS患者のLVポンプの性能を健康な対照群と比較するために.
主な方法:
- 伝導性カテーテル/マイクロマノメーターのテクニックを用いて,一時的な下静脈閉を施しました.
- 9人の多発性硬化症患者と8人の年齢マッチングした対照群で圧力と体積の関係を生成した.
- 患者のサブセットにおける風船弁膜整形手術の評価された効果.
主要な成果:
- 多発性硬化症の患者は,対照群と比較して,心臓の出力量と終盤腹動量の減少を示した.
- 筋収縮機能は,MS患者と対照群の間で比較可能でした.
- 多発性硬化症の患者は,左にシフトした,そしてより急な終端の縮小圧-体積関係 (従順度が低い) による縮小圧機能の障害を示した.
結論:
- 側頭管狭窄はダイアストリック機能を低下させ,LV準拠の低下が特徴です.
- バルーンバルブ整形手術は,この下痢性障害を急激に逆転させ,追跡時に持続的な効果をもたらします.
- LV準拠の低下は,異常なミトラバルブ装置に対する心室結合からの機能的制限による可能性が高い.
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