Fisman E Z, Beker B, Vered Z, Barasch E, Shimoni Z, Motro M
Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Cardiology. 1994;85(5):352-6. doi: 10.1159/000176734.
Two patients with acute tricuspid bacterial endocarditis in which a normal right ventricular Doppler filling pattern was demonstrated early following valvectomy are reported. After surgery, on pulsed Doppler examination, the sample volume positioned at the right atrioventricular level revealed a normal M-shaped filling pattern. A pathologic monophasic pattern was documented a few months later. Our findings suggest that early after surgery the preserved gradient throughout ventricular diastole leads to a passive and active filling similar to normal. Only at a later stage is the grossly dilated right atrium unable to maintain active filling, and the 'A' wave disappears despite the fact that sinus rhythm is maintained. Tricuspid valve diastolic motion represents a product of the several factors that determine atrioventricular gradient, but the valve itself appears not to be involved in the generation of a normal filling pattern.
报道了两名急性三尖瓣细菌性心内膜炎患者，在瓣膜切除术后早期，右心室多普勒充盈模式正常。术后，经脉冲多普勒检查，位于右房室水平的取样容积显示出正常的M型充盈模式。几个月后记录到病理性单相模式。我们的研究结果表明，术后早期整个心室舒张期保留的压力阶差导致类似于正常的被动和主动充盈。只有在后期，明显扩张的右心房无法维持主动充盈，尽管维持了窦性心律，但“A”波消失。三尖瓣舒张期运动是决定房室压力阶差的几个因素的产物，但瓣膜本身似乎不参与正常充盈模式的产生。
