Kori Y, Suma K, Shiroma K, Koyama Y, Narumi J, Nishiyama K
Department of Cardiovascular Surgery, Tokyo Women's Medical College Second Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1988 Aug;89(8):1273-8.
Thirty-five patients with tetralogy of Fallot (TF), were studied for the postoperative factors which might have some effect on the presence and severity of ventricular premature contraction (VPC) and exercise performance (EP). Using the factors, we tried to make VPC- and EP-scores. Of the 35 patients, 12 (34%) showed VPCs of Lown's grade 2 or higher (group B) and 23 (66%) were free from significant VPCs (group A). Group B patients were found to have significantly higher postoperative right to left ventricular peak systolic pressure ratios (RV/LV) and higher right ventricular peak systolic pressures (RVP) than those of group A. The right ventricular regional wall motion (RVRWM) in the right ventricular outflow tracts of group B patients showed akinetic or paradoxical movements. VPC-scores using RV/LV, RVP and RVRWM showed that 11 patients, whose score were 0, were free from significant VPCs and showed that 6 of 7 patients (86%), whose score were 3, demonstrated significant VPCs. It was shown that RV/LV, left ventricular ejection fraction (LVEF), CTR and pulmonary regurgitation (PR) affected the exercise tolerance. In the case of EP-scores, using RV/LV, LVEF, CTR and PR, the endurance times of the patients who had higher scores seemed to be shorter. VPC- and EP-scores as a tool for predicting the presence of VPCs and the level of exercise performance seem to be quite useful.
对35例法洛四联症（TF）患者进行了研究，以探讨可能对室性早搏（VPC）的发生和严重程度以及运动能力（EP）有影响的术后因素。利用这些因素，我们试图制定VPC评分和EP评分。在这35例患者中，12例（34%）出现洛恩分级2级或更高的室性早搏（B组），23例（66%）无明显室性早搏（A组）。发现B组患者术后右心室与左心室收缩压峰值比（RV/LV）显著高于A组，右心室收缩压峰值（RVP）也更高。B组患者右心室流出道的右心室局部壁运动（RVRWM）显示运动减弱或矛盾运动。使用RV/LV、RVP和RVRWM的VPC评分显示，11例评分为0的患者无明显室性早搏，7例评分为3的患者中有6例（86%）出现明显室性早搏。结果表明，RV/LV、左心室射血分数（LVEF）、心胸比率（CTR）和肺动脉反流（PR）影响运动耐力。就EP评分而言，使用RV/LV、LVEF、CTR和PR，评分较高的患者的耐力时间似乎较短。VPC评分和EP评分作为预测室性早搏的存在和运动能力水平的工具似乎非常有用。
