Fujino S, Nakano K, Aomi S, Nakatani H, Hagino I, Uchita S, Nishida H, Endo M, Hashimoto A, Koyanagi H
Department of Cardiovascular Surgery, Tokyo Women's Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jun;42(6):860-4.
144 surgical patients with isolated aortic valve disease were reviewed to determine the incidence and the mechanism of pulmonary hypertension (PH). The hemodynamic data revealed PH (pulmonary artery systolic pressure of 40 mmHg or more) in 18 patients (12.6%). There was a positive correlation between left ventricular end-diastolic pressure (LVEDP) and pulmonary artery pressure. After operation the pulmonary artery pressure normalized in all cases but 2 patients in early post-operative period. In patients with aortic stenosis with PH, LVEDP/LVEDVI ratio was higher than that of patients without PH, which showed left ventricular diastolic dysfunction. In patients with aortic regurgitation with PH, the cause of elevated LVEDP was not only severe long-standing regurgitation with ventricular dysfunction, but also the imbalancement of compensation by dilated ventricle with preserved left ventricular function.
对144例孤立性主动脉瓣疾病的外科手术患者进行回顾性研究,以确定肺动脉高压(PH)的发生率和机制。血流动力学数据显示,18例患者(12.6%)存在PH(肺动脉收缩压40 mmHg及以上)。左心室舒张末期压力(LVEDP)与肺动脉压力之间呈正相关。术后除2例患者在术后早期肺动脉压力未恢复正常外,所有患者的肺动脉压力均恢复正常。在合并PH的主动脉瓣狭窄患者中,LVEDP/LVEDVI比值高于无PH的患者,提示左心室舒张功能障碍。在合并PH的主动脉瓣关闭不全患者中,LVEDP升高的原因不仅是严重的长期反流伴心室功能障碍,还包括左心室功能正常但心室扩张导致的代偿失衡。