Yamagishi T, Ozaki M, Furutani Y, Yamamoto K, Saeki A, Sato S, Ichioka T, Matsuda Y, Kusukawa R, Nakatsuka M
Second Department of Internal Medicine, Yamaguchi University School of Medicine, Ube.
J Cardiol. 1990;20(1):103-9.
To assess the effects of wall motion abnormalities of the anterior left ventricle and interventricular septum on right ventricular (RV) systolic and diastolic filling function, multiple-gated radionuclide angiography was performed at rest in 53 patients with previous anteroseptal myocardial infarction and 14 normal subjects. There were 26 patients with left ventricular ejection fraction (LVEF) greater than or equal to 45% (group 1) and 27 with LVEF less than 45% (group 2). Six measurements were obtained simultaneously in both ventricles: 1) EF, 2) peak ejection rate, 3) duration of systole, 4) peak filling rate, 5) time to the peak filling rate, and 6) ratio of the peak filling rate to the peak ejection rate. The mean RV ejection fraction and the peak ejection rate in groups 1 and 2 were similar to those in the normal subjects. The ratio of the peak RV filling rate to the peak RV ejection rate, a sensitive indicator of diastolic filling function, decreased significantly in group 1 (0.61 +/- 0.15, p less than 0.02) and group 2 (0.59 +/- 0.15, p less than 0.02) as compared with that in the normal subjects (0.74 +/- 0.14). This indicates an impairment of early diastolic RV filling compared with RV systolic function. Thus, RV systolic function appears to be normally maintained even when anteroseptal wall motion is severely impaired; however, even in the presence of mild anteroseptal wall motion abnormality, RV filling may be impaired without reduced RV systolic function.
为评估左心室前壁和室间隔运动异常对右心室(RV)收缩及舒张充盈功能的影响,对53例既往有前间隔心肌梗死的患者及14名正常受试者进行了静息状态下的多门控放射性核素血管造影检查。其中左心室射血分数(LVEF)大于或等于45%的患者有26例(第1组),LVEF小于45%的患者有27例(第2组)。同时对两个心室进行六项测量:1)射血分数(EF),2)峰值射血率,3)收缩期持续时间,4)峰值充盈率,5)达到峰值充盈率的时间,6)峰值充盈率与峰值射血率之比。第1组和第2组的右心室平均射血分数和峰值射血率与正常受试者相似。作为舒张充盈功能敏感指标的右心室峰值充盈率与右心室峰值射血率之比,在第1组(0.61±0.15,p<0.02)和第2组(0.59±0.15,p<0.02)中较正常受试者(0.74±0.14)显著降低。这表明与右心室收缩功能相比,右心室舒张早期充盈受损。因此,即使前间隔运动严重受损,右心室收缩功能似乎仍能正常维持;然而,即使存在轻度的前间隔运动异常,右心室充盈也可能受损而右心室收缩功能并未降低。