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左心室心肌僵硬度的临床评估

Clinical evaluation of left ventricular myocardial stiffness.

作者信息

Tomoda H

出版信息

Jpn Heart J. 1978 Jan;19(1):74-83. doi: 10.1536/ihj.19.74.

Abstract

Left ventricular myocardial stiffness was calculated in clinical cases. Thirty patients who underwent diagnostic cardiac catheterization were studied. Left ventricular cineangiograms and simultaneously recorded left ventricular pressure tracings were analyzed. The left ventricular stiffness constant k, was computed by substituting the left ventricular myocardial stress (sigma) and strain (epsilon) throughout the period between the end of rapid ventricular filling and the beginning of atrial contraction, in the equation sigma = b.ek.epsilon. Left ventricular myocardial stiffness was measured as follows: Group I (normal): 9.6 +/- 4.3, Group II (mitral stenosis): 10.7 +/- 4.0, Group III (left ventricular volume overload): 12.1 +/- 4.2, Group IV (coronary artery disease without myocardial infarction): 8.6 +/- 2.5, and Group V (myocardial infarction): 23.6 +/- 7.4. All of the normal cases showed stiffness constants of less than 15 and maxVcf of more than 2.0 circ/sec, and all the patients with histories of heart failure in Groups III to V showed stiffness constants of more than 15 and maxVcf of less than 1.0 circ/sec. For the rest of the patients, measurements of the stiffness constant were valuable for the assessment of patients' clinical status, especially when combined with contractility.

摘要

在临床病例中计算左心室心肌僵硬度。研究了30例接受诊断性心导管检查的患者。分析了左心室电影血管造影和同时记录的左心室压力曲线。通过将快速心室充盈末期至心房收缩开始期间的左心室心肌应力(σ)和应变(ε)代入方程σ = b·e^k·ε来计算左心室僵硬度常数k。左心室心肌僵硬度测量如下:第一组(正常):9.6±4.3,第二组(二尖瓣狭窄):10.7±4.0,第三组(左心室容量超负荷):12.1±4.2,第四组(无心肌梗死的冠状动脉疾病):8.6±2.5,第五组(心肌梗死):23.6±7.4。所有正常病例的僵硬度常数均小于15,最大心室周径缩短率(maxVcf)大于2.0次/秒,第三组至第五组中所有有心力衰竭病史的患者的僵硬度常数均大于15,最大心室周径缩短率小于1.0次/秒。对于其余患者,僵硬度常数的测量对于评估患者的临床状况很有价值,尤其是与收缩性相结合时。

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