圧縮性 perikarditisの特徴的なドップラー特徴を明らかにするために,プレロードの減少. 新しい観察ができた
J K Oh1, A J Tajik, C P Appleton
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
Circulation
|February 18, 1997
まとめ
収縮性心周炎では,ミトラルE速度の鈍化した呼吸器の変動は,プレロードを減らすことによってマスクを解除することができます. 左心室の充填圧を低下させるための操作は,ドップラー心声検査の特徴的な変化を明らかにし,診断を助けました.
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
- 医療診断 医療診断
背景:
- 狭窄性心膜炎の診断は,ミトラルE速度 (>= 25%) の呼吸器の変動を示すドップラーエコーカルディオグラフィに依存しています.
- 収縮性心周炎の患者のサブセットは,呼吸器の変動が鈍化または欠如し,診断を複雑にします.
- 左心房圧の上昇は,典型的な呼吸器の変化を覆い隠し,さらなる調査を必要とする可能性があります.
研究 の 目的:
- プレロードの減少が,収縮性心周炎の疑いのある患者のミトラルE速度における呼吸器の変動を明らかにできるかどうかを判断する.
- 特徴的なドップラー検出を明らかにする左心室の充填圧を下げるためのマニュアルの有効性を評価する.
主な方法:
- 手術で確認された収縮性心周炎と,ミトラルE速度における発端呼吸器の変動の<25%の12人の患者の遡及的分析.
- 重複ドップラーエコーカルディオグラフィは,プレロードの減量マニュアル (頭が上向きに傾くか,座っている位置) を実行した後に行われます.
- 前負荷の減少前後のミトラルE速度と呼吸器の変動の比較.
主要な成果:
- ベースラインの平均ミトラルE速度は,最小限の呼吸器の変動を示した (5 +/- 7%).
- プレロードを減らす後,インスピレーションのミトラルE速度 (0.61 +/- 0.13 m/s,P < .004) の有意な減少が観察されました.
- 呼吸器の変動は32 +/- 28%に増加し,75%の患者が>=25%の変動を達成しました.
結論:
- プレロード減少マニュバーは,収縮性心周炎におけるミトラルE速度における呼吸器の変動を明らかにするのに効果的です.
- 予備負荷の減少後にドップラーエコーカルディオグラフィーを繰り返すのは,最初の発見が不確実である場合に推奨されます.
- このテクニックは,典型的なドップラーパターンが欠けていても,収縮性心膜炎を診断するのに役立ちます.
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