Izumi S, Miyatake K, Beppu S, Yamagishi M, Akiyama T, Hiraoka H, Yamamoto K, Suzuki S, Nagata S, Sakakibara H
National Cardiovascular Center, Research Institute and Hospital, Suita.
J Cardiol. 1990;20(2):311-9.
The filling modes into the right atrium and both ventricles were observed using pulsed Doppler echocardiography in six cases of restrictive myocardial diseases, and these were compared with those of 13 cases of constrictive pericarditis, six cases of lone atrial fibrillation and 16 healthy subjects. Special attention was paid to the mechanical properties of the cardiac walls which might be reflected in the filling modes. 1. In the restrictive cases, right atrial filling from the superior caval vein during ventricular systole was reduced in velocity and duration, but the atrial filling during ventricular diastole was not appreciably changed. This flow pattern was similar to that of lone atrial fibrillation, indicating reduced distensibility or impaired contraction and ejection fraction of the right atrium. In constrictive pericarditis, the right atrial filling time was shortened both in ventricular systole and diastole, reflecting stiffening of the pericardium. 2. In the restrictive cases, the first half of the left ventricular rapid filling wave was steep and the skirt of the descending limb was prolonged, while there was no such tendency in the right ventricle. In constrictive pericarditis, the rapid filling time was shortened in the right ventricle, and was not significantly changed in the left ventricle. 3. The differences in the atrial and ventricular filling patterns between restrictive myocardial disease and constrictive pericarditis may serve to distinguish these two disease entities.
采用脉冲多普勒超声心动图观察了6例限制性心肌病患者右心房和双心室的充盈模式,并与13例缩窄性心包炎患者、6例孤立性房颤患者及16例健康受试者的充盈模式进行了比较。特别关注了可能反映在充盈模式中的心脏壁机械特性。1. 在限制性病例中,心室收缩期上腔静脉向右心房的充盈速度和持续时间降低,但心室舒张期的心房充盈无明显变化。这种血流模式与孤立性房颤相似,提示右心房扩张性降低或收缩及射血分数受损。在缩窄性心包炎中,心室收缩期和舒张期右心房的充盈时间均缩短,反映心包变硬。2. 在限制性病例中,左心室快速充盈波的前半部分陡峭,下降支的波尾延长,而右心室无此趋势。在缩窄性心包炎中,右心室的快速充盈时间缩短,左心室无明显变化。3. 限制性心肌病和缩窄性心包炎在心房和心室充盈模式上的差异可能有助于区分这两种疾病实体。