Jose Benny, Rane Sameer, Kevadiya Hiren, Dubey Gajendra, Bohora Shomu, Prajapati Jayesh
Jupiter Hospital, Pune, Maharashtra, India.
U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India.
Clin Med Insights Circ Respir Pulm Med. 2023 Jan 25;17:11795484231152985. doi: 10.1177/11795484231152985. eCollection 2023.
To study the respiratory variation of right atrial (RA) pressures at baseline and during atrioventricular nodal reentry tachycardia (AVNRT).
Of the 23 patients screened, 16 participants with typical AVNRT were included in the study. After ensuring adequate hydration, baseline RA pressures were measured as the height of 'a' and 'v' waves. The patients were asked to take deep breaths, and the measurements were taken in both inspiration and expiration.
Of the 16 participants, 14(87.5%) showed a normal fall in the height of 'a' and 'v' waves with inspiration, 1(6.25%) showed no change and 1(6.25%) showed a rise in height at baseline, <0.01. During induced AVNRT, the 'a' and 'v' wave heights increased in 8(50%), remained same in 6(37.5%) and showed a normal fall in 2(12.5%), = 0.07 for 'a' waves and = 0.09 for 'v' waves. When the magnitude and direction of change in 'a' and 'v' wave height at baseline was compared with AVNRT, it showed a significant difference with 13(81.25%) participants demonstrating positive , <0.01. Mean age was numerically higher in those with a more considerable inspiratory rise in RA pressures but was not statistically significant, χ(2) = 3.1, = 0.21.
does occur in a substantial number of patients during AVNRT. Clinical appreciation of this phenomenon is possible in half to three-fourth of patients, provided the mean RA pressures are low enough for the variation to be visible in the neck.
研究基线状态及房室结折返性心动过速（AVNRT）期间右心房（RA）压力的呼吸变化。
在筛选的23例患者中，16例典型AVNRT参与者纳入研究。确保充分补液后，测量基线RA压力，即“a”波和“v”波的高度。要求患者深呼吸，并在吸气和呼气时进行测量。
16例参与者中，14例（87.5%）吸气时“a”波和“v”波高度正常下降，1例（6.25%）无变化，1例（6.25%）基线时高度升高，<0.01。诱发AVNRT期间，8例（50%）“a”波和“v”波高度增加，6例（37.5%）保持不变，2例（12.5%）正常下降，“a”波=0.07，“v”波=0.09。将基线时“a”波和“v”波高度变化的幅度和方向与AVNRT时进行比较，13例（81.25%）参与者显示阳性，差异有统计学意义，<0.01。RA压力吸气时升高更明显者平均年龄在数值上更高，但无统计学意义，χ(2)=3.1，=0.21。
AVNRT期间相当一部分患者确实会出现这种情况。如果平均RA压力足够低，以至于在颈部能够观察到变化，那么半数至四分之三的患者有可能从临床上认识到这一现象。
