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ID 16356
Eprint ID
16356
フルテキストURL
Thumnail 98_893.pdf 2.08 MB
タイトル(別表記)
Echocardiographic evaluation of left ventricular function in mitral stenosis in association with submitral lesion
著者
内田 俊明 岡山大学医学部第一内科学教室
抄録
The functional and morphological changes in the left ventricle were assessed in 43 patients with mitral stenosis (MS) using echocardiography. The MS patient group consisted of 24 patients with sinus rhythm and 23 with atrial fibrillation. The cardiac functions of the patients were from I to Ⅲ according to the New York Heart Association (NYHA) classification. The control group included 14 normal subjects and 3 with lone atrial fibrillation. The left ventricular ejection fractions (EF) at rest and in response to a bicycle ergometer (10 watts for 3 min) were examined by echocardiography. Comparison of the EF by echocardiography to the index by radionuclide angiography proved the efficacy of echocardiography for estimating LV function in patients with MS. Morphological changes in the left ventricle were caused by submitral lesions. These changes were quantitatively represented by a deformity ratio (DR). The EF at rest in the MS patients with atrial fibrillation was lower than in the remaining groups, and the MS patients with sinus rhythm showed an EF similar to that of normal subjects and lone atrial fibrillation patients. Some of the MS patients with atrial fibrillation had a higher EF while others had a lower EF. After exercise, the EF of the MS patients with sinus rhythm, who had NYHA class Ⅲ cardiac function, decreased due to reduction of left ventricular end-diastolic dimension (LVDd) caused by an increased heart rate (HR) and total peripheral resistance (TPR). EFs of the remaining subjects were augmented after exercise. The relationships between the resting EF and other hemodynamic parameters measured were investigated to verify which factors influence left ventricular function in MS patients. There were no significant relationships between EF and mitral valve area (MVA), LVDd, HR or TPR. However, the DR closely correlated to the EF with a correlation coefficient of -0.75. Surgical treatment of the mitral valve improved both the cardiac function as to the NYHA class and the EF at rest, along with significant recovery of the DR. The percent change in the EF varied inversely with that in the DR (correlation coefficient, -0.57). Response of the EF to exercise was also improved after surgery. Therefore, it is concluded that left ventricular deformities of patients with MS induced by subvalvular lesion limits the left ventricular function and causes a lower EF.
キーワード
僧帽弁狭窄
心エコー図
左室機能
弁下部病変
左室変形率(Deformity ratio, DR)
発行日
1986-10-31
出版物タイトル
岡山医学会雑誌
出版物タイトル(別表記)
Journal of Okayama Medical Association
98巻
9-10号
出版者
岡山医学会
出版者(別表記)
Okayama Medical Association
開始ページ
893
終了ページ
907
ISSN
0030-1558
NCID
AN00032489
資料タイプ
学術雑誌論文
オフィシャル URL
https://www.jstage.jst.go.jp/article/joma1947/98/9-10/98_9-10_893/_article/-char/ja/
関連URL
http://www.okayama-u.ac.jp/user/oma/index.html
言語
Japanese
著作権者
岡山医学会
論文のバージョン
publisher
査読
有り
Eprints Journal Name
joma