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[法洛四联症修复术后肺动脉反流对左心室功能的影响]

[The influence of pulmonary regurgitation on left ventricular function after repair of tetralogy of Fallot].

作者信息

Kato H, Nakano S, Matsuda H, Shimazaki Y, Kishimoto H, Taniguchi K, Miura T, Ogawa M, Sano T, Kawashima Y

机构信息

First Department of Surgery, Osaka University Medical School, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1990 Nov;38(11):2257-63.

PMID:2280099
Abstract

The influence of right ventricular (RV) volume overload by pulmonary regurgitation (PR) on left ventricular (LV) function was evaluated postoperatively in 23 patients with tetralogy of Fallot (TF). The age at operation was 3.1 +/- 1.7 (mean +/- SD) years. The age at postoperative study was 5.9 +/- 2.0 years. We determined RV end-diastolic volume (%RVEDV), RV ejection fraction (EF), %LVEDV, LV end-systolic volume (%LVESV), LVEF, and LV end-systolic stress (ESS)/%LVESV. Patients were divided into 2 groups on the basis of presence or absence of RV volume overload by PR as follows: The %RVEDV (175 +/- 23%) of group 1 (n = 10) was 150% greater than normal RVEDV. Group 2 (n = 13) had normal %RVEDV (108 +/- 23%). Preoperatively, there had been no differences in hemoglobin, %RVEDV, RVEF, %LVEDV, LVEF, and in the ratio of average cross-sectional area of the left and right pulmonary arteries to cross-sectional area of the normal right pulmonary artery between the 2 groups. Moreover, there were no differences in age at repair, or during postoperative study, nor in the postoperative ratio of RV to LV systolic pressure between the 2 groups. RVEF was significantly less in group 1 than in group 2 (0.53 +/- 0.05 vs 0.58 +/- 0.05, p less than 0.05). %LVEDV and %LVESV in group 1, 138 +/- 10% and 171 +/- 30% respectively, were significantly greater than those in group 2, 116 +/- 11% and 133 +/- 20% respectively (p less than 0.001 in %LVEDV and p less than 0.01 in %LVESV).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对23例法洛四联症(TF)患者术后评估了肺动脉反流(PR)导致的右心室(RV)容量超负荷对左心室(LV)功能的影响。手术时年龄为3.1±1.7(平均±标准差)岁。术后研究时年龄为5.9±2.0岁。我们测定了RV舒张末期容积(%RVEDV)、RV射血分数(EF)、%LVEDV、LV收缩末期容积(%LVESV)、左心室射血分数(LVEF)以及LV收缩末期应力(ESS)/%LVESV。根据PR导致的RV容量超负荷情况将患者分为2组:第1组(n = 10)的%RVEDV(175±23%)比正常RVEDV大150%。第2组(n = 13)的%RVEDV正常(108±23%)。术前,两组之间在血红蛋白、%RVEDV、RVEF、%LVEDV、LVEF以及左右肺动脉平均横截面积与正常右肺动脉横截面积之比方面无差异。此外,两组在修复时年龄、术后研究期间年龄以及术后RV与LV收缩压之比方面也无差异。第1组的RVEF显著低于第2组(0.53±0.05对0.58±0.05,p<0.05)。第1组的%LVEDV和%LVESV分别为138±10%和171±30%,显著高于第2组的116±11%和133±20%(%LVEDV中p<0.001,%LVESV中p<0.01)。(摘要截断于250字)

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