Sack S, Henrichs K J, Erbel R, Wittlich N, Meyer J
II. Medical Clinic, University of Mainz, Germany.
Cathet Cardiovasc Diagn. 1992 Jun;26(2):82-91. doi: 10.1002/ccd.1810260203.
Transesophageal echocardiography was used to study the effect of the balloon inflation on left ventricular function in 20 patients with critical aortic stenosis undergoing balloon valvuloplasty. Balloon inflation caused an increase of end-diastolic (15% to 34%) and end-systolic (57% to 72%) left ventricular volume. Left ventricular wall stress increased from 30 +/- 10 x 10(3) dyn/cm2 at diastole and 121 +/- 40 x 10(3) dyn/cm2 at systole to 44 +/- 11 x 10(3) dyn/cm2 and 191 +/- 55 x 10(3) dyn/cm2, respectively, when the balloon was inflated (P less than 0.05). Turbulent regurgitant jet across the mitral valve increased from 15 +/- 2% to 25 +/- 3% during balloon inflation (P less than 0.01). Continued monitoring of left ventricular function after balloon deflation demonstrated prolonged enlargement of left ventricular volumes. Our data show that balloon inflation causes an increase of left ventricular volume and impairment of contraction. Increase of left ventricular wall stress--associated with a reduction of coronary blood flow, due to lower aortic pressure--could result in ischemic myocardial injury.
采用经食管超声心动图研究20例接受球囊瓣膜成形术的重症主动脉瓣狭窄患者球囊充盈对左心室功能的影响。球囊充盈使左心室舒张末期容积增加（15%至34%），收缩末期容积增加（57%至72%）。球囊充盈时，左心室壁应力分别从舒张期的30±10×10³达因/平方厘米和收缩期的121±40×10³达因/平方厘米增加至44±11×10³达因/平方厘米和191±55×10³达因/平方厘米（P<0.05）。球囊充盈期间，二尖瓣反流湍流束从15±2%增加至25±3%（P<0.01）。球囊放气后对左心室功能的持续监测显示左心室容积持续扩大。我们的数据表明，球囊充盈导致左心室容积增加和收缩功能受损。左心室壁应力增加——由于主动脉压力降低导致冠状动脉血流减少——可能导致缺血性心肌损伤。
