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主动脉瓣置换术前及术后患者收缩期时间间期的适用性(作者译)

[The applicability of systolic time intervals in patients before and after aortic valve replacement (author's transl)].

作者信息

Haerten K, Erbel F M, Kuhn H, Leuner C, Loogen F

出版信息

Z Kardiol. 1979 Jul;68(7):469-76.

PMID:473848
Abstract

In order to evaluate the systolic time intervals (STI) for characterizing the left ventricular pump function and the clinical course in patients with aortic valve disease, 35 patients with aortic stenosis (AS) and 25 patients with aortic insufficiency (AI class III or IV (NYHA) were studied before and 1 year after valve replacement either with Björk-Shiley, Lillehie-Kaster or Starr-Edwards aortic prostheses. Left ventricular ejection time index (LVETI), preejection period index (PEPI) and PEP/LVET were determined and compared with cardiac index (CI), stroke volume index (SVI) and ejection fraction (EF). Prosthetic valve replacement leads to a high significant decrease of LVETI from preop. 468 +/- 31 ms to postop. 394 +/- 26 ms (mean normal values 415 ms) and an increase of PEPI from 100 +/- 26 ms to 136 +/- 25 ms (normal 132 ms) as of PEP/LVET from 0.21 +/- 0.09 to 0.41 +/- 0.12 (normal 0.31). Pre- as well as postop. there is no difference in STI between AS and AI. Also the groups with the three prosthetic valve types do not differ significantly. LVETI and PEPI correlate only postop. with CI and SVI, but PEP/LVET correlates well with EF (r = -0.73) before and after operation. The comparison of STI with the hemodynamic data suggest that preop. values of STI near normal and postop. LVETI below, PEPI and PEP/LVET above the mean values of the whole group with aortic valve replacement indicate left ventricular pump dysfunction. The STI are helpful in the pre-/postop. follow-op of patients with severe aortic valve disease to characterize the clinical and hemodynamic course.

摘要

为了评估收缩期时间间期(STI)以表征主动脉瓣疾病患者的左心室泵功能及临床病程,对35例主动脉瓣狭窄(AS)患者和25例主动脉瓣关闭不全(AI,纽约心脏协会(NYHA)分级III或IV级)患者在使用Björk-Shiley、Lillehie-Kaster或Starr-Edwards主动脉人工瓣膜进行瓣膜置换术前及术后1年进行了研究。测定左心室射血时间指数(LVETI)、射血前期指数(PEPI)和PEP/LVET,并与心脏指数(CI)、每搏量指数(SVI)和射血分数(EF)进行比较。人工瓣膜置换导致LVETI从术前的468±31毫秒显著降低至术后的394±26毫秒(平均正常值415毫秒),PEPI从100±26毫秒增加至136±25毫秒(正常为132毫秒),PEP/LVET从0.21±0.09增加至0.41±0.12(正常为0.31)。术前及术后,AS和AI患者的STI无差异。三种人工瓣膜类型的组间也无显著差异。LVETI和PEPI仅在术后与CI和SVI相关,但PEP/LVET在术前和术后均与EF密切相关(r = -0.73)。STI与血流动力学数据的比较表明,术前STI值接近正常,术后LVETI低于、PEPI和PEP/LVET高于主动脉瓣置换术全组平均值提示左心室泵功能障碍。STI有助于对重度主动脉瓣疾病患者进行术前/术后随访,以表征临床和血流动力学病程。

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