Hasegawa J, Kitamura S, Kawachi K, Kawata T, Niwaya K, Kameda Y, Mizuguchi K, Kobayashi S, Yoshida Y
Department of Surgery III, Nara Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Aug;43(8):1132-7.
Cardiac catheterization was performed to measure pressure gradients and hemodynamic parameters at rest and during supine bicycle exercise in 37 patients with aortic valve replacements, using allograft valves. Bicer prosthetic valves and SJM prosthetic valves of 19 to 27 mm diameter. Fourteen patients had an allograft valve replacement, 17 a Bicer valve, and 6 a St. Jude Medical valve. Patients were comparable for age, valve size, body surface area and left ventricular systolic function. There were no statistical differences among three groups for body surface area, left ventricular end-systolic and end-diastolic volume indices, exercise cardiac index, exercise heart rate, or workload achieved. In all 37 patients left ventricular and ascending aortic pressures were measured simultaneously according to the Brockenbrough method. In a 21 mm valve size, the mean pressure gradient was higher for Bicer and St. Jude Medical prosthetic valves than for allograft valves, both at rest (8.0 +/- 3.5 mmHg for Bicer, 5.0 +/- 1.4 mmHg for St. Jude Medical versus 0 +/- 0 mmHg for allograft; p < 0.05) and during exercise (11.0 +/- 4.9 mmHg, 10.0 +/- 2.8 mmHg versus 0 +/- 0 mmHg, respectively: p < 0.05). In a 23 mm size, there were no significant differences among three groups for resting mean pressure gradient, but during exercise the mean pressure gradient was higher for Bicer and St. Jude Medical prosthetic valves than for allograft valves (8.4 +/- 9.3 mmHg, 5.5 +/- 4.4 mmHg versus 0 +/- 0 mmHg; p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
对37例使用同种异体瓣膜进行主动脉瓣置换的患者进行了心导管检查,以测量静息状态及仰卧位自行车运动期间的压力阶差和血流动力学参数。使用的是直径为19至27毫米的双叶人工瓣膜和圣犹达医疗公司(SJM)的人工瓣膜。14例患者进行了同种异体瓣膜置换,17例使用双叶瓣膜,6例使用圣犹达医疗瓣膜。患者在年龄、瓣膜大小、体表面积和左心室收缩功能方面具有可比性。三组在体表面积、左心室收缩末期和舒张末期容积指数、运动心指数、运动心率或达到的工作量方面无统计学差异。按照布罗肯布罗方法,对所有37例患者同时测量左心室和升主动脉压力。在瓣膜尺寸为21毫米时,双叶瓣膜和圣犹达医疗人工瓣膜的平均压力阶差在静息时(双叶瓣膜为8.0±3.5毫米汞柱,圣犹达医疗瓣膜为5.0±1.4毫米汞柱,同种异体瓣膜为0±0毫米汞柱;p<0.05)和运动时(分别为11.0±4.9毫米汞柱、10.0±2.8毫米汞柱和0±0毫米汞柱;p<0.05)均高于同种异体瓣膜。在瓣膜尺寸为23毫米时,三组静息平均压力阶差无显著差异,但运动时双叶瓣膜和圣犹达医疗人工瓣膜的平均压力阶差高于同种异体瓣膜(8.4±9.3毫米汞柱、5.5±4.4毫米汞柱和0±0毫米汞柱;p<0.05)。(摘要截取自250字)