逆行性熱性連続性心筋麻痺が右心室機能に与える影響
M LeBoutillier1, E A Grossi, B M Steinberg
1Department of Surgery, New York University Medical Center, NY 10016.
Circulation
|November 1, 1994
まとめ
逆行性熱継続性心不全 (RWCC) は,心臓手術後の右心室機能回復を損なう可能性があります. この方法は,逆行性冷たい多用量心筋麻痺と比較して,RV機能の有意な低下を示し,慎重に使用することを保証しました.
科学分野:
- 心血管外科手術についてです.
- 筋動脈の保存について
- 静脈の機能 静脈の機能 静脈の機能
背景:
- 逆行性熱継続性心不全 (RWCC) は,心筋の保存技術として提案されている.
- RWCCが右心室 (RV) 機能に与える影響に関するデータは限られている.
- 以前の研究では,逆行的な方法で,RVと心室間隔膜への心臓麻痺の分布が悪いことが示唆されています.
研究 の 目的:
- 逆行性熱継続性心不全 (RWCC) の後の右心室の機能的保存を評価する.
- RWCCと逆行性冷たい多用量心筋麻痺 (RCMC) のRV機能回復を比較する.
主な方法:
- モングレル犬 (n=14) は,アンテグラード停止後,RWCC (n=7) またはRCMC (n=7) のいずれかで90分間の大動脈クロスクランプを施した.
- 左心室と右心室 (LV,RV) の圧力-体積関係は,ソノミクロメーターと圧力トランスデューサを使用して測定されました.
- 静脈機能は,閉塞前と閉塞解除後の30分と60分で評価された.
主要な成果:
- RWCCは,RCMC (79.40% +/- 13.82%),RCMC (41.03% +/- 7.49%) と比較して,再注入後30分後にRV機能回復が著しく低下した.
- 再輸血後60分後,RWCC (48.05% +/- 9.72%) とRCMC (61.95% +/- 8.70%) の間で,RV機能は低いままでした.
- RWCCとRCMCの間では,両方の時点において,LV機能回復において有意な差異は観察されなかった.
結論:
- 逆行性熱継続性心不全 (RWCC) は,RVの機能障害の可能性を示しています.
- RCMCは,RWCCと比較して優れたRV機能回復を提供しているようです.
- RWCCを使用する際には,特に既にあるRV縮症を有する患者の場合,注意が必要です.
関連する概念動画
Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy IV: Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...


