Abe H, Tomotsune K
Jpn Circ J. 1982 Jan;46(1):103-12. doi: 10.1253/jcj.46.103.
The etiology and clinical significance of asynchronous relaxation of the left ventricle during isovolumic relaxation period was studied. Fifty patient with angina pectoris, 50 with myocardial infarction, 40 with normal heart, 20 with mitral stenosis and 10 with mitral prolapse syndrome were investigated. Asynchronous relaxation was observed in the following order: 72% in angina pectoris, 46% in myocardial infarction, 30% in mitral valve prolapse and 10% in both pure mitral stenosis and normal heart. In left anterior descending coronary artery disease, asynchronous relaxation was observed in 80%. Asynchronous relaxation seen before aortocoronary bypass graft to the left anterior descending coronary artery either disappeared or decreased after surgery. The contractility of the site, where asynchronous relaxation was seen, was normal in most cases and akinetic in none. The results of this study suggest the possibilities that asynchronous relaxation is at least partially related to localized myocardial ischemia and that it may be an early phenomenon of the effect of myocardial ischemia. With regard to asynchronous relaxation and hemodynamic alterations, force-velocity lissajous was analysed. Distortion of the lissajous in relaxation phase was seen in 73% who showed asynchrony. This distortion can be interpreted as indication of ununiformity of the left ventricular relaxation.
研究了等容舒张期左心室异步舒张的病因及临床意义。对50例心绞痛患者、50例心肌梗死患者、40例心脏正常者、20例二尖瓣狭窄患者和10例二尖瓣脱垂综合征患者进行了调查。观察到异步舒张的发生率依次为：心绞痛患者72%，心肌梗死患者46%，二尖瓣脱垂患者30%，单纯二尖瓣狭窄和心脏正常者均为10%。在左前降支冠状动脉疾病患者中，异步舒张的发生率为80%。在左前降支冠状动脉进行主动脉冠状动脉搭桥术前出现的异步舒张，术后要么消失，要么减轻。大多数情况下，出现异步舒张部位的心肌收缩力正常，无一例运动不能。本研究结果提示，异步舒张至少部分与局部心肌缺血有关，且可能是心肌缺血影响的早期现象。关于异步舒张与血流动力学改变，分析了力-速度利萨如图形。在表现为异步舒张的患者中，73%在舒张期出现利萨如图形扭曲。这种扭曲可解释为左心室舒张不均匀的表现。
