Lumia F J, LaManna M, Gonzalez-Lavin L, Maranhao V
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, New Jersey 08015.
Clin Cardiol. 1988 Apr;11(4):205-8. doi: 10.1002/clc.4960110403.
The long-term effects of valve replacement for chronic isolated aortic regurgitation as assessed by first-pass exercise radionuclide angiography have never been reported. We studied 20 males and 5 females before, 15 months postoperatively, and from 29 to 109 (mean 62 +/- 21) months following valve replacement with exercise radionuclide angiography. Mean peak heart rate did not change for the three studies. Peak systolic blood pressure decreased from 201 +/- 42 mmHg to 185 +/- 24 mmHg at 15 months and further declined to 177 +/- 32 mmHg by the long-term study (p less than 0.03). The mean resting left ventricular ejection fraction improved from 44 +/- 15% preoperatively to 57 +/- 18% at 15 months (p less than 0.002) with no further improvement by the long-term evaluation. The postexercise ejection fraction improved from 42 +/- 13% preoperatively to 61 +/- 21% at 15 months (p less than 0.002) also with no change by the long-term study. The duration of exercise improved from 9.7 +/- 4.6 min to 11.9 +/- 3.4 min (p less than 0.03) at 15 months with no additional improvement long term. Improvement in resting and postexercise ejection fraction and in exercise duration is maximal at 15 months. Accuracy and cost containment suggest that assessment of the maximal change in ejection fraction by exercise radionuclide angiography after aortic valve replacement in asymptomatic patients be limited to the 15-month interval.
首次通过运动放射性核素血管造影术评估慢性单纯主动脉瓣反流瓣膜置换术的长期效果，此前从未有过相关报道。我们对20名男性和5名女性在瓣膜置换术前、术后15个月以及术后29至109（平均62±21）个月进行了运动放射性核素血管造影术研究。三项研究的平均峰值心率均未改变。收缩压峰值在术后15个月从201±42 mmHg降至185±24 mmHg，到长期研究时进一步降至177±32 mmHg（p<0.03）。静息左心室射血分数平均值从术前的44±15%提高到术后15个月的57±18%（p<0.002），长期评估时无进一步改善。运动后射血分数从术前的42±13%提高到术后15个月的61±21%（p<0.002），长期研究时也无变化。运动持续时间在术后15个月从9.7±4.6分钟提高到11.9±3.4分钟（p<0.03），长期无额外改善。静息和运动后射血分数以及运动持续时间的改善在15个月时最大。准确性和成本控制表明，对于无症状患者主动脉瓣置换术后通过运动放射性核素血管造影术评估射血分数的最大变化，应限于15个月的间隔期。
