Hoshino T, Tomonaga G, Motomura M, Shimono Y, Kinoshita M, Kusukawa R
Jpn Circ J. 1977 Oct;41(10):1085-97. doi: 10.1253/jcj.41.1085.
The left ventricular systolic ejection phase was cineangiographically analyzed in an attempt to evaluate left ventricular performance. Forty-eight patients were classified into five groups: (1) 9 controls; (2) 5 patients with PMD (congestive type) (COCM); (3) 9 patients with PMD hypertrophic type) (HCM), (4) 9 patients with ischemic heart disease (IHD); and (5) 16 patients with mitral stenosis (MS). The rate of volume change (deltaV/deltat) and the volume change as a percentage of stroke volume (deltaV/SV) in patients with COCM and IHD were lower in the early systole and higher in the mid-systole as compared with the control group. Normalized systolic ejection rate (NSER) and velocity of circumferential fiber shortening (Vcf) for the early and late systole were significantly lower in patients with COCM and IHD than in the control group. In two patients with IHD in whom normal indices of left ventricular performance and no asynergy were observed, NSER and Vcf were normal in the late systole but were significantly lower in the early systole. In all 48 patients, deltaV/deltat, deltaV/SV, NSER and Vcf were compared statistically with conventional ejection phase indices and isometric phase indices. delthV/SV for the midstystole showed a negative correlation with EF, MNSER and mVcf. NSER and Vcf for all three phases showed a good correlation with Vmax, max dp/dt and R-max dp/dt but a better correlation with EF, MNSER and mVcf. It was concluded that NSER and Vcf for the early systole were sensitive indices of left ventricular performance and may be utilized to detect subtle depression of left ventricular performance.
为了评估左心室功能，对左心室收缩期射血阶段进行了心血管造影分析。48例患者被分为五组：（1）9名对照组；（2）5例充血型原发性心肌病（COCM）患者；（3）9例肥厚型原发性心肌病（HCM）患者；（4）9例缺血性心脏病（IHD）患者；（5）16例二尖瓣狭窄（MS）患者。与对照组相比，COCM和IHD患者在收缩早期的容积变化率（deltaV/deltat）和作为每搏量百分比的容积变化（deltaV/SV）较低，而在收缩中期较高。COCM和IHD患者收缩早期和晚期的归一化收缩期射血率（NSER）和圆周纤维缩短速度（Vcf）显著低于对照组。在两名左心室功能指标正常且无运动失调的IHD患者中，NSER和Vcf在收缩晚期正常，但在收缩早期显著降低。对所有48例患者的deltaV/deltat、deltaV/SV、NSER和Vcf与传统射血期指标和等容期指标进行了统计学比较。收缩中期的delthV/SV与射血分数（EF）、平均归一化收缩期射血率（MNSER）和平均圆周纤维缩短速度（mVcf）呈负相关。所有三个阶段的NSER和Vcf与最大速度（Vmax）、最大dp/dt和R-最大dp/dt有良好的相关性，但与EF、MNSER和mVcf的相关性更好。得出的结论是，收缩早期的NSER和Vcf是左心室功能的敏感指标，可用于检测左心室功能的细微下降。
