Yamakado T, Shiba K, Kasai A, Fukui A, Murayama S, Nakano T
First Department of Internal Medicine, Mie University, Tsu.
J Cardiol. 1991;21(1):97-104.
We analyzed left ventricular (LV) pulsus alternans in 49 patients with hypertrophic cardiomyopathy during cardiac catheterization. LV pulsus alternans was noted in 6 of 17 patients with hypertrophic obstructive cardiomyopathy, 5 of whom already showed intraventricular pressure gradient at rest. No patient with hypertrophic non-obstructive cardiomyopathy had LV pulsus alternans. Pulsus alternans was neither observed in the right ventricle nor in the pulmonary artery. There was little, if any, pulsus alternans in a low pressure LV chamber (subaortic portion) and peripheral artery during LV pulsus alternans in a high pressure chamber. LV end-diastolic pressure also remained unchanged during LV pulsus alternans, except in one case. It is suggested that LV pulsus alternans in hypertrophic obstructive cardiomyopathy may imply LV dysfunction associated with increased afterload.
我们在49例肥厚型心肌病患者进行心导管检查期间分析了左心室（LV）搏动交替。在17例肥厚型梗阻性心肌病患者中，有6例出现左心室搏动交替，其中5例在静息时已显示室内压梯度。肥厚型非梗阻性心肌病患者均无左心室搏动交替。右心室和肺动脉均未观察到搏动交替。在高压腔室出现左心室搏动交替时，低压左心室腔（主动脉下部分）和外周动脉几乎没有搏动交替（即便有也很少）。除1例患者外，左心室搏动交替期间左心室舒张末期压力也保持不变。提示肥厚型梗阻性心肌病中的左心室搏动交替可能意味着与后负荷增加相关的左心室功能障碍。
