左心室の充填圧のドップラー推定は,ミトラバルブ病の患者で実施された
Abhinav Diwan1, Abhvinav Diwan, Marti McCulloch
1Section of Cardiology, University of Cincinnati, Cincinnati, Ohio, USA.
Circulation
|June 16, 2005
まとめ
初期ダイアストリックミトラ流入 (E) と環状初期ダイアストリック速度 (Ea) (T(E-Ea)) の間の時間間隔に対するイソヴォルメトリックリラクゼーション時間 (IVRT) の比率は,ミトラ弁疾患の患者における肺毛細血管ケイジ圧力 (PCWP) を正確に推定します. この方法は,バルブ手術後のPCWPの変化も追跡します.
科学分野:
- 心臓病学 心臓病学
- 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
- 心臓生理学 心臓生理学
背景:
- 従来のドップラーエコーカルディオグラフィは,ミトラ弁疾患 (MVD) の左心房圧 (LAP) の予測に限界があります.
- バルブ面積,左心室 (LV) のリラックス,および硬さなどの要因は,従来の測定を混乱させます.
- 時間の区間T ((E-Ea) は,これらの混同変数とは無関係です.
研究 の 目的:
- MVDの患者における左心房圧 (LAP) を推定するためのT(E-Ea) 間隔の有用性を評価する.
- T(E-Ea) が従来のドップラー測定の限界を克服できるかどうかを評価する.
主な方法:
- 同時に2次元のドップラー検査,組織ドップラー画像検査 (TDI) エコーカルディオグラフィー,右心系カテーテリゼーションを51人のMVD患者で実施した.
- 患者には,ミトラルリグルジテーション (MR) とミトラル狭窄症 (MS) の患者も含まれていました.
- イソボリュレメトリックリラクゼーション時間 (IVRT) とT (E-Ea) の比率は,肺毛細血管の平均圧 (PCWP) と相関していた.
主要な成果:
- IVRTとT ((E-Ea) の比率は,MR (r=-0.92) とMS (r=-0.88) の両方の患者でPCWPと強い相関を示しました.
- この比率とIVRT/tauは,他のドップラー測定と比較して,PCWPと最も良い相関性を示した.
- この比率は,PCWPの変化を正確に追跡したもので,PCWPが5mmHg以上または5mmHg以上であることも含め,繰り返し試験および心房細動患者における変化を正確に追跡した.
結論:
- IVRTとT ((E-Ea) の比率は,MVD患者の平均PCWPを推定するための信頼できる方法を提供します.
- このエコーカーディオグラフィック比率は,弁手術後のPCWP変化を効果的にモニタリングすることができます.
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