Sütsch G, Jenni R, Krayenbühl H P
Department of Internal Medicine, Medical Policlinic, Cardiology, University Hospital Zürich, Switzerland.
Eur Heart J. 1991 Oct;12(10):1132-9. doi: 10.1093/oxfordjournals.eurheartj.a059847.
The occurrence of a left ventricular anterograde flow velocity (maximal: 3.9 m.s-1) is demonstrated in a 32-year-old patient with hypertrophic cardiomyopathy and midventricular obstruction, beginning at early systole and persisting throughout the isovolumic relaxation. Cardiac catheterization with simultaneous dual high fidelity pressure measurements in the apical and basal chambers confirmed the presence of the Doppler maximal instantaneous pressure gradient of 60 mmHg. Contrast left ventricular angiography excluded apical dyskinesia. In the two intracavity compartments, isovolumic relaxation time and the time constant of pressure decay (tau) were abnormal whereby tau was more delayed in the apical than in the basal portion. The presence of an apical high pressure zone during systole with impeded and delayed emptying through the midventricular obstacle and the late onset and prolongation of relaxation are thought to be the cause of the intraventricular flow from apex to base lasting from early systole throughout isovolumic relaxation.
在一名32岁肥厚型心肌病伴心室中部梗阻的患者中，观察到左心室顺行血流速度（最大值：3.9 m·s⁻¹），始于收缩早期并持续至等容舒张期。通过心导管术同时对心尖部和基底部腔室进行双高保真压力测量，证实存在60 mmHg的多普勒最大瞬时压力阶差。左心室造影排除了心尖运动障碍。在两个心腔内隔室中，等容舒张时间和压力衰减时间常数（tau）均异常，心尖部的tau比基底部延迟更明显。收缩期心尖部高压区的存在，通过心室中部障碍物排空受阻且延迟，以及舒张期延迟开始和延长，被认为是导致从收缩早期至等容舒张期持续存在的心室内从心尖向心底血流的原因。
