Alonso Gómez A M, Rodríguez J A, Torres A, Villaroel M T, Cordo J C, Díaz A, Martínez Ferrer J B, Camacho I
Unidad Funcional de Cardiología, Hospital Txagorritxu, Vitoria-Gasteiz.
Rev Esp Cardiol. 1990 Feb;43(2):87-92.
The aim of the present study was to assess the effect of changes in preload induced by nitrates on calculated mitral valve area by Doppler pressure half-time. Forty patients (mean age 51 +/- 10 years), 23 with mitral stenosis, ten with mechanical prosthesis and seven with bioprosthesis were studied by Doppler echocardiography. Twelve were in sinus rhythm and 28 had atrial fibrillation. Mitral valve area by Doppler pressure half-time, peak and mean mitral gradient and pulmonary artery systolic pressure were measured before and after isosorbide dinitrate (5 mg) or nitroglycerin (0.4 mg). The nitrates produced a significant reduction of pre-load in total group (p less than 0.001) but did not change the mitral valve area (1.9 +/- 0.8 to 1.9 +/- 0.8). The subsets of patients with size valvular area (greater than 2 cm2, less than 2 cm2, less than 1.5 cm2, mechanical prosthesis, bioprosthesis, sinus rhythm and atrial fibrillation) had an insignificant change in mitral valve area after administration of nitrates. We conclude that the mitral valve area by Doppler pressure half-time method do not modify in different conditions of preload. These findings remain in patients with prosthesis, different sizes of mitral valve area and atrial fibrillation.
本研究的目的是评估硝酸盐诱导的前负荷变化对通过多普勒压力半衰期计算的二尖瓣面积的影响。通过多普勒超声心动图对40例患者(平均年龄51±10岁)进行了研究,其中23例患有二尖瓣狭窄,10例有人工机械瓣膜,7例有生物瓣膜。12例为窦性心律,28例有房颤。在给予二硝酸异山梨酯(5毫克)或硝酸甘油(0.4毫克)前后,测量了通过多普勒压力半衰期得出的二尖瓣面积、二尖瓣峰值和平均压差以及肺动脉收缩压。硝酸盐使整个组的前负荷显著降低(p<0.001),但二尖瓣面积未改变(从1.9±0.8变为1.9±0.8)。瓣膜面积大小不同(大于2平方厘米、小于2平方厘米、小于1.5平方厘米)、人工机械瓣膜、生物瓣膜、窦性心律和房颤的患者亚组在给予硝酸盐后二尖瓣面积变化不显著。我们得出结论,通过多普勒压力半衰期法得出的二尖瓣面积在不同的前负荷条件下不会改变。这些发现也适用于有人工瓣膜、不同二尖瓣面积大小以及有房颤的患者。