Asai M, Oki T, Tominaga T, Fukuda N, Ishimoto T, Ohgushi H, Taoka M, Niki T, Mori H
J Cardiogr. 1983 Jun;13(2):371-81.
In order to evaluate left ventricular function in atrial septal defect (ASD), 12 cases with ASD, 18 postoperative cases of ASD and 27 normal controls were examined by means of exercise echocardiography using supine bicycle ergometer (50 watts and 3 min). M-mode echocardiograms and left ventricular (LV) short-axis views by two-dimensional echocardiography were subjected to the observation. M-mode echocardiographic studies: ASD group showed an increased stroke dimension (SD) during exercise mainly due to a marked increase of left ventricular end-diastolic dimension ( LVDd ) and a slight decrease of left ventricular end-systolic dimension ( LVDs ). Postoperative ASD group showed an increased SD during exercise mainly due to a marked decrease of LVDs and a slight decrease of LVDd . On the other hand, in normal control group exercise increased SD only by a significant decrease of LVDs . Right ventricular dimension was decreased during exercise in ASD group, but did not change significantly in postoperative ASD and normal control groups. During exercise in ASD group, peak velocity of circumferential fiber shortening (VCF) was increased most markedly, and negative peak VCF was decreased most strikingly. Eight of 12 patients with ASD who showed abnormal interventricular septal motion demonstrated remarkable improvement of the motion during exercise. Two-dimensional echocardiographic studies: Left ventricular short-axis views demonstrated that the shape of the left ventricular cavity changed from flattened to more circular configuration during exercise at end- and early-diastole in ASD group. The shape of the left ventricular cavity at late-systole did not change significantly during exercise in this group. In postoperative ASD group, the left ventricular short-axis view demonstrated circular configuration of the left ventricle at end-diastole both in rest and during exercise. The shape of the left ventricular cavity did not change by exercise. It was concluded that in ASD group cardiac output is increased during exercise by decreasing a left to right shunt at the atrial level and increasing left ventricular filling rate. Therefore, the left ventricular function was found to be good in ASD.
为评估房间隔缺损（ASD）患者的左心室功能，对12例ASD患者、18例ASD术后患者及27例正常对照者采用仰卧位自行车测力计（50瓦，3分钟）进行运动超声心动图检查。观察M型超声心动图及二维超声心动图的左心室（LV）短轴切面。M型超声心动图研究：ASD组运动时心搏量（SD）增加，主要是由于左心室舒张末期内径（LVDd）显著增加及左心室收缩末期内径（LVDs）轻度减小。ASD术后组运动时SD增加，主要是由于LVDs显著减小及LVDd轻度减小。另一方面，正常对照组运动时SD仅因LVDs显著减小而增加。ASD组运动时右心室内径减小，但ASD术后组及正常对照组无明显变化。ASD组运动时，圆周纤维缩短峰值速度（VCF）增加最为显著，负向峰值VCF减小最为明显。12例ASD患者中，8例室间隔运动异常者运动时室间隔运动有显著改善。二维超声心动图研究：左心室短轴切面显示，ASD组在舒张末期和舒张早期运动时，左心室腔形状从扁平变为更接近圆形。该组在收缩末期运动时左心室腔形状无明显变化。ASD术后组，左心室短轴切面显示静息及运动时舒张末期左心室均呈圆形结构。运动时左心室腔形状无变化。结论为，ASD组运动时心输出量增加是通过减少心房水平的左向右分流及增加左心室充盈率实现的。因此，发现ASD患者左心室功能良好。
