Nakano K, Nakatani H, Endo M, Magosaki N, Tamura K, Sugawara M, Koyanagi H
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Jan;43(1):14-8.
To evaluate the effects of CABG on regional function of the left ventricular wall, regional work of the left ventricular anterior wall was calculated before and after CABG in 8 patients with multivessel coronary artery disease. In all patients, including CABG for LAD branch, complete revascularization was performed. Regional work of the left ventricular wall was calculated as RW (mJ/cm3) = - integral of sigma d epsilon, where sigma = wall stress and epsilon = regional strain (1n (1/H): H = wall thickness). A major and a minor axis, and anterior wall thickness during cardiac cycle were obtained from the left ventriculogram. Preoperatively, the RW varied widely (from -0.9 to 13.3 mJ/cm3). In 4 cases, the RW decreased and in the other cases, it increased. The RW converged in the tight range (from 2.5 to 6.7 mJ/cm3), postoperatively. These results suggest a uniformalization of the RW in the different regions of the left ventricle was established after the complete revascularization. We conclude that the RW obtained from the analyses of sigma-epsilon relationship is a useful index for evaluating the effects of CABG on the treated region of the left ventricle.
为评估冠状动脉旁路移植术(CABG)对左心室壁局部功能的影响,对8例多支冠状动脉疾病患者在CABG术前和术后计算左心室前壁的局部功。在所有患者中,包括对左前降支(LAD)分支进行CABG,均实现了完全血运重建。左心室壁的局部功计算为RW(mJ/cm³)=-σdε的积分,其中σ=壁应力,ε=局部应变(1n(1/H):H=壁厚)。从左心室造影中获取心动周期中的长轴、短轴和前壁厚度。术前,RW变化很大(从-0.9至13.3 mJ/cm³)。4例患者的RW降低,其他患者的RW升高。术后,RW集中在较窄范围(从2.5至6.7 mJ/cm³)。这些结果表明,完全血运重建后左心室不同区域的RW实现了均匀化。我们得出结论,通过分析σ-ε关系获得的RW是评估CABG对左心室治疗区域影响的有用指标。