Stewart R A, McKenna W J
Department of Medicine, Hammersmith Hospital, London, England.
Am J Cardiol. 1990 Jan 15;65(3):226-30. doi: 10.1016/0002-9149(90)90089-j.
This study assesses how differences in residual volume and heart rate influence the measurement and interpretation of commonly used indexes of left ventricular filling obtained by radionuclide ventriculography. Thirty patients with hypertrophic cardiomyopathy (HC) and 26 normal subjects were studied. The time to peak filling rate (168 +/- 42 vs 139 +/- 35 ms; p = 0.006) and time to 30% filling (154 +/- 32 vs 131 +/- 29 ms; p = 0.009 were prolonged in patients with HC compared to normal subjects, suggesting impaired early diastolic filling. However the peak filling rate, measured in end-diastolic counts/s, was greater in patients with HC (3.31 +/- 0.89 vs 3.06 +/- 0.51, p = 0.19). This measurement was influenced by the relative residual volume (HC r = 0.41, p less than 0.001; normal r = 0.29, difference not significant), which was smaller in patients with HC (22.4 +/- 8.0 vs 35.5 +/- 5.6%; p less than 0.0001). The peak filling rate measured in stroke volume counts did not vary with the relative residual volume (HC r = 0.10, difference not significant; normal r = 0.21, difference not significant) and was less than normal in patients with HC (4.27 +/- 0.69 vs 4.72 +/- 1.0; p = 0.58). There was a strong association between the first third filling fraction and the heart rate (HC r = 0.66, p less than 0.001; normal r = 0.71, p less than 0.001), reflecting its dependence on the duration of the first third of diastole.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究评估了残气量和心率的差异如何影响通过放射性核素心室造影获得的常用左心室充盈指标的测量和解读。研究了30例肥厚型心肌病（HC）患者和26名正常受试者。与正常受试者相比，HC患者的充盈峰值时间（168±42 vs 139±35毫秒；p = 0.006）和30%充盈时间（154±32 vs 131±29毫秒；p = 0.009）延长，提示舒张早期充盈受损。然而，以舒张末期计数/秒测量的充盈峰值率在HC患者中更高（3.31±0.89 vs 3.06±0.51，p = 0.19）。该测量受相对残气量影响（HC r = 0.41，p<0.001；正常r = 0.29，差异不显著），HC患者的相对残气量较小（22.4±8.0 vs 35.5±5.6%；p<0.0001）。以每搏量计数测量的充盈峰值率不随相对残气量变化（HC r = 0.10，差异不显著；正常r = 0.21，差异不显著），且HC患者低于正常水平（4.27±0.69 vs 4.72±1.0；p = 0.58）。前三分之一充盈分数与心率之间存在强关联（HC r = 0.66，p<0.001；正常r = 0.71，p<0.001），反映了其对舒张期前三分之一持续时间的依赖性。（摘要截短于250字）
