充血性心力衰竭患者中传播速度的前负荷依赖性变化。

Preload-dependent variation of the propagation velocity in patients with congestive heart failure.

作者信息

Seo Yoshihiro, Ishimitsu Toshiyuki, Ishizu Tomoko, Obara Kenichi, Moriyama Naoko, Sakane Michiko, Maeda Hiroshi, Watanabe Shigeyuki, Yamaguchi Iwao

机构信息

Department of Internal Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Ibaraki, Japan.

出版信息

J Am Soc Echocardiogr. 2004 May;17(5):432-8. doi: 10.1016/j.echo.2004.01.009.

DOI:10.1016/j.echo.2004.01.009

PMID:15122182

Abstract

BACKGROUND

Although color Doppler M-mode propagation velocity (Vp) is preload-independent, the variation in Vp with the temporal variation of preload in the clinical setting has not been evaluated. Because left ventricular filling pressure changes dramatically with treatment of congestive heart failure (CHF), we hypothesized that preload-dependent variations in Vp occur with treatment of CHF.

METHODS

We performed Doppler echocardiographic and hemodynamic evaluation in 24 patients with CHF (15 men, 62 +/- 10 years) at initial presentation (baseline study) and after CHF had improved with therapy (second study).

RESULTS

The interval between the baseline and the second study was 48.6 +/- 21.5 hours. Vp decreased between the baseline study (41 +/- 5 cm/s) and the second study (28 +/- 5 cm/s, P <.0001). Only the change in pulmonary capillary wedge pressure (-8.3 +/- 3.3 mm Hg) between the baseline and second study was an independent predictor of the change in Vp (-12.5 +/- 5.9 cm/s) by stepwise linear regression (r = 0.68, P =.0002).

CONCLUSIONS

Vp decreases significantly with decreases in pulmonary capillary wedge pressure with the treatment of CHF. The preload-dependent variation should be taken into account in the assessment of Vp in patients with CHF.

摘要

背景

尽管彩色多普勒M型传播速度（Vp）与前负荷无关，但在临床环境中Vp随前负荷的时间变化情况尚未得到评估。由于左心室充盈压在充血性心力衰竭（CHF）治疗过程中变化显著，我们推测在CHF治疗过程中会出现Vp的前负荷依赖性变化。

方法

我们对24例CHF患者（15例男性，年龄62±10岁）在初次就诊时（基线研究）以及CHF经治疗改善后（第二次研究）进行了多普勒超声心动图和血流动力学评估。

结果

基线研究与第二次研究之间的间隔为48.6±21.5小时。Vp在基线研究时（41±5 cm/s）到第二次研究时（28±5 cm/s，P<.0001）降低。通过逐步线性回归分析，仅基线研究与第二次研究之间肺毛细血管楔压的变化（-8.3±3.3 mmHg）是Vp变化（-12.5±5.9 cm/s）的独立预测因素（r = 0.68，P =.0002）。