Sanada H, Shimizu M, Kita Y, Sugihara N, Shimizu K, Murakami T, Takeda R, Mifune J
Second Department of Internal Medicine, Kanazawa University School of Medicine.
J Cardiol. 1992;22(1):99-106.
In patients with hypertrophic cardiomyopathy (HCM) and essential hypertension (HT), left ventricular dysfunction in early diastole which is associated with left atrial contraction plays an important role in left ventricular filling. To evaluate left atrial booster pump function, we analyzed left atrial preload (left atrial pressure at the end of diastasis; LAPd, left atrial volume index at the end of diastasis; LAVd), left atrial afterload (left ventricular end-diastolic pressure; LVEDP, left ventricular chamber stiffness constant; K), and left atrial ejection indices (left atrial ejection fraction during atrial contraction; LAEF, left atrial ejection volume index during atrial contraction; ACVI). The study subjects consisted of control subjects (n = 5), HT patients (n = 6), and HCM patients (n = 11). The left ventricular wall was significantly thicker in the HT and HCM groups. The left ventricular rapid filling volume index was less in the HT group, and significantly less in the HCM than in the control group. LAPd and LAVd were greater in the HT group than in the control group, and greater in the HCM group than in the HT group. LVEDP and K were greater in the HT group than in the control group, and significantly greater in the HCM group than in the other 2 groups. ACVI was greater in the HT group than in the control group, but in the HCM group, ACVI was significantly less than in the HT group and did not differ significantly from that in the control group. LAEF was significantly less in the HCM group than in the other 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS)
在肥厚型心肌病(HCM)和原发性高血压(HT)患者中,与左心房收缩相关的舒张早期左心室功能障碍在左心室充盈中起重要作用。为评估左心房辅助泵功能,我们分析了左心房前负荷(舒张末期左心房压力;LAPd,舒张末期左心房容积指数;LAVd)、左心房后负荷(左心室舒张末期压力;LVEDP,左心室腔僵硬度常数;K)以及左心房射血指数(心房收缩期左心房射血分数;LAEF,心房收缩期左心房射血容积指数;ACVI)。研究对象包括对照组(n = 5)、HT患者(n = 6)和HCM患者(n = 11)。HT组和HCM组的左心室壁明显更厚。HT组的左心室快速充盈容积指数低于对照组,HCM组显著低于对照组。HT组的LAPd和LAVd高于对照组,HCM组高于HT组。HT组的LVEDP和K高于对照组,HCM组显著高于其他两组。HT组的ACVI高于对照组,但HCM组的ACVI显著低于HT组,与对照组无显著差异。HCM组的LAEF显著低于其他两组。(摘要截选至250词)