Ishimoto T, Asai M, Tominaga T, Ohkushi H, Taoka M, Ohshima C, Fukuda N, Oki T, Niki T, Mori H
J Cardiogr. 1984 Oct;14(3):521-35.
To evaluate left ventricular function in patients (pts) with right ventricular overload, exercise echocardiographic studies using a bicycle ergometer were performed for seven pts with pulmonary hypertension (PH), two with cor pulmonale (CP) and 16 with atrial septal defects (ASD), and the results were compared with those of 10 (control I) and 27 (control II) normal persons. These subjects were categorized in two study groups; study I consisting of PH, CP and control group I with an exercise workload of 25 watts for 3 min; and study II consisting of ASD and control group II with an exercise workload of 50 watts for 3 min. The results were as follows: M-mode echocardiography revealed that: During exercise, the stroke volume (SV) was increased with a significant decrease of left ventricular end-systolic dimension (LVDs), but without a change in left ventricular end-diastolic dimension (LVDd) in control groups I and II, with a marked increase of LVDd and a slight decrease of LVDs in the ASD group. By contrast, the SV in the PH group tended to decrease during exercise with a slight decrease of LVDd, but without a significant change in LVDs. Right ventricular dimension (RVD) was significantly increased during exercise in the PH group, but was decreased in the ASD group. In control groups I and II, RVD did not change during exercise. In ASD, and control groups I and II, the peak velocity of circumferential fiber shortening (Vcf) was increased during exercise, and the peak negative Vcf was significantly decreased. However, these parameters exhibited impaired responses during exercise in the PH group. Abnormal interventricular septal (IVS) motion at rest tended to become normal during exercise in 12 of 16 pts with ASD. In all pts with PH, however, IVS motion did not change substantially during exercise. There were similar parameter responses between the PH and CP groups. Two-dimensional echocardiography showed that: The left ventricular short-axis view demonstrated a diastolic left ventricular configuration which changed from oblique to relatively circular orientation during exercise in the ASD group. In four of five pts with PH, the diastolic configuration of the left ventricle was oblique because of a loss of the normal curvature of the IVS at rest and during exercise. The diastolic left ventricular configuration improved during exercise in only one pt with PH, with slightly elevated pulmonary arterial systolic pressure as in the ASD group.(ABSTRACT TRUNCATED AT 400 WORDS)
为评估右心室负荷过重患者的左心室功能，对7例肺动脉高压（PH）患者、2例肺心病（CP）患者和16例房间隔缺损（ASD）患者使用自行车测力计进行运动超声心动图研究，并将结果与10名正常人（对照组I）和27名正常人（对照组II）进行比较。这些受试者被分为两个研究组；研究I包括PH、CP患者以及运动负荷为25瓦、持续3分钟的对照组I；研究II包括ASD患者以及运动负荷为50瓦、持续3分钟的对照组II。结果如下：M型超声心动图显示：运动期间，对照组I和II的每搏输出量（SV）增加，左心室收缩末期内径（LVDs）显著减小，但左心室舒张末期内径（LVDd）无变化；ASD组LVDd显著增加，LVDs略有减小。相比之下，PH组运动期间SV趋于减小，LVDd略有减小，但LVDs无显著变化。PH组运动期间右心室内径（RVD）显著增加，而ASD组RVD减小。对照组I和II运动期间RVD无变化。在ASD组以及对照组I和II中，运动期间圆周纤维缩短峰值速度（Vcf）增加，负向Vcf峰值显著减小。然而，PH组运动期间这些参数的反应受损。16例ASD患者中有12例静息时室间隔（IVS）运动异常在运动期间趋于正常。然而，所有PH患者运动期间IVS运动无明显变化。PH组和CP组之间有相似的参数反应。二维超声心动图显示：左心室短轴视图显示，ASD组运动期间左心室舒张期形态从斜形变为相对圆形。5例PH患者中有4例，由于静息和运动时IVS正常曲率丧失，左心室舒张期形态为斜形。仅1例PH患者运动期间左心室舒张期形态改善，其肺动脉收缩压略升高，与ASD组情况相同。（摘要截取自400字）
