Peter C A, Jones R H
Arch Surg. 1980 Nov;115(11):1348-52. doi: 10.1001/archsurg.1980.01380110082012.
Radionuclide angiocardiography was used to measure left ventricular ejection fraction and end-diastolic volume while at rest and during exercise in 20 patients with severe aortic insufficiency. A second study was performed one year later in ten of these patients who did not undergo aortic valve replacement and in ten patients one year after operation. In patients without aortic valve replacement, the maximum ejection fraction achieved during exercise was 63% +/- 9% during the first study, and decreased to 57% +/- 9% after one year without a change in ejection fraction while at rest. No change in end-diastolic volume either while at rest or during exercise occurred during that period of time. In patients undergoing aortic valve reconstruction, the most striking change after one year was a decrease in end-diastolic volume from 296 +/- 107 to 148 +/- 37 mL at rest and from 306 +/- 92 to 155 +/- 38 mL during exercise. Ejection fraction increased by 10% at rest and 12% during exercise. Therefore, medically treated patients with aortic insufficiency lost the ability to increase ejection fraction during exercise without alteration of the ejection fraction while at rest over the one year of study. In contrast, aortic valve reconstruction resulted in a decrease in end-diastolic volume and an increase in ejection fraction during rest and exercise.
对20例严重主动脉瓣关闭不全患者在静息和运动时进行放射性核素心血管造影，以测量左心室射血分数和舒张末期容积。一年后，对其中10例未接受主动脉瓣置换术的患者以及10例术后一年的患者进行了第二项研究。在未接受主动脉瓣置换术的患者中，第一项研究期间运动时达到的最大射血分数为63%±9%，一年后降至57%±9%，而静息时射血分数无变化。在此期间，静息或运动时舒张末期容积均无变化。在接受主动脉瓣重建术的患者中，一年后最显著的变化是静息时舒张末期容积从296±107 mL降至148±37 mL，运动时从306±92 mL降至155±38 mL。静息时射血分数增加10%，运动时增加12%。因此，在一年的研究期间，接受药物治疗的主动脉瓣关闭不全患者在运动时失去了增加射血分数的能力，而静息时射血分数未改变。相比之下，主动脉瓣重建术导致静息和运动时舒张末期容积减小，射血分数增加。
