Yatabe S, Hirabayashi M, Ushizima K, Tominaga H, Fujisaki N
Kaizuka Hospital.
Kokyu To Junkan. 1991 Sep;39(9):911-6.
We investigated transmitral flow dynamics before (B) and after (A) hemodialysis (HD). Pulsed Doppler echocardiography was performed in 15 patients (10 males and 6 females, with a mean age of 51) with neither valvular disease nor heart failure. After HD, systolic and diastolic pressure declined significantly to [156 +/- 27----135 +/- 24mmHg (p less than 0.01) and 84 +/- 16----75 +/- 15mmHg (p less than 0.02)] respectively. However, heart rate did not change. Doppler derived indexes were peak early filling velocity (E), peak filling during atrial contribution (A), early filling time velocity integral (IE), atrial time velocity integral (IA), and percent atrial contribution [IA/(IE + IA) x 100] (%A) There was a positive correlation between E and peak systolic stress (r = 0.437, p less than 0.05). Conclusion; In HD, early diastolic filling is dependent on preload. It is necessary to consider preload when diastolic function is assessed.
我们研究了15例（10例男性和6例女性，平均年龄51岁）既无瓣膜疾病也无心力衰竭患者血液透析（HD）前（B）和后（A）的经二尖瓣血流动力学。采用脉冲多普勒超声心动图进行检查。血液透析后，收缩压和舒张压分别显著下降至[156±27----135±24mmHg（p<0.01）和84±16----75±15mmHg（p<0.02）]。然而，心率未发生变化。多普勒得出的指标包括早期充盈峰值速度（E）、心房收缩期充盈峰值（A）、早期充盈时间速度积分（IE）、心房时间速度积分（IA）以及心房贡献率[IA/（IE+IA）×100]（%A）。E与收缩期峰值应力之间存在正相关（r=0.437，p<0.05）。结论：在血液透析中，舒张早期充盈取决于前负荷。评估舒张功能时必须考虑前负荷。
