Caglar N M, Araki H, Taira Y, Fukuyama T, Nakamura M
Jpn Heart J. 1985 May;26(3):425-36. doi: 10.1536/ihj.26.425.
Right ventricular systolic and diastolic function was studied in patients with ischemic heart disease using equilibrium radionuclide ventriculography. In patients with inferior myocardial infarction and proximal right coronary lesions, the right ventricular ejection fraction (0.43 +/- 0.06, n = 10, mean +/- SD) and peak filling rate (1.7 +/- 0.4 EDV/sec) were lower than normals (0.57 +/- 0.07 and 2.7 +/- 0.4 EDV/sec, n = 10, p less than 0.001, respectively). In these patients, the right ventricular time to peak filling rate was longer than in normals (225 +/- 36 msec vs 136 +/- 45 msec, p less than 0.001), while the left ventricular ejection fraction remained normal. In patients with inferior myocardial infarction and distal right coronary lesions, the right ventricular ejection fraction, peak filling rate and time to peak filling rate were not different from those in normals. Even in patients with proximal right coronary lesions, the right ventricular ejection fraction was normal unless they had an inferior myocardial infarction. A decreased left ventricular ejection fraction and abnormal motion of the ventricular septum did not affect the right ventricular ejection fraction. The present results suggest that patients with an inferior myocardial infarction and proximal right coronary lesion often develop right ventricular systolic and diastolic dysfunction.
采用平衡放射性核素心室造影术对缺血性心脏病患者的右心室收缩和舒张功能进行了研究。在下壁心肌梗死和右冠状动脉近端病变的患者中,右心室射血分数(0.43±0.06,n = 10,均值±标准差)和峰值充盈率(1.7±0.4 EDV/秒)低于正常水平(0.57±0.07和2.7±0.4 EDV/秒,n = 10,p均小于0.001)。在这些患者中,右心室达到峰值充盈率的时间比正常人长(225±36毫秒对136±45毫秒,p小于0.001),而左心室射血分数保持正常。在下壁心肌梗死和右冠状动脉远端病变的患者中,右心室射血分数、峰值充盈率和达到峰值充盈率的时间与正常人无差异。即使在右冠状动脉近端病变的患者中,除非合并下壁心肌梗死,右心室射血分数也是正常的。左心室射血分数降低和室间隔运动异常并不影响右心室射血分数。目前的结果表明,下壁心肌梗死合并右冠状动脉近端病变的患者常出现右心室收缩和舒张功能障碍。