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[肺静脉顺应性异常对二尖瓣置换术临床结果的影响]

[Effect of improper pulmonary venous compliance on clinical results of mitral valve replacement].

作者信息

Korewicki J, Pogorzelska H, Biederman A, Rajecka A, Zieliński T, Sadowski A

机构信息

II Kliniki Wad Serca, Instytutu Kardiologii, Warszawie.

出版信息

Pneumonol Alergol Pol. 1993;61(11-12):568-73.

PMID:8148754
Abstract

The pulmonary venous vascular volume and its compliance (PVcomp) are important factors influencing filling of the left ventricle. It seems that a poor PVcomp effects the value and reversibility of secondary pulmonary hypertension. Basing on Hirakawa's method PVcomp (= 0.4'' x SV/V-d) was calculated in 34 patients with isolated mitral stenosis (SM). Basing on the mean value of PVcomp the group was divided into those with poor (< = 4.3 ml/mmHg) and good (4.4 and more ml/mmHg) PVcomp. Prior mitral valve replacement (MVR) the groups did not differ in values of PAP, PWP, SVI, PVR assessed at rest. During exercise (25 Watt) in the supine position significant higher values of PAP and PWP were observed in patients with poor compliance. Six months after MVR the PAP and PWP values normalized in all patients. In the patients with the initial good PVcomp values significantly higher values of SVI and a decrease in PVR was found. During exercise (25 Watts) significantly higher values of PAP and PVR were registered in patients with initial poor PVcomp values. Pulmonary venous compliance may be an independent factors influencing the clinical outcome of mitral valve replacement 6 months after the procedure.

摘要

肺静脉血管容量及其顺应性(PVcomp)是影响左心室充盈的重要因素。似乎PVcomp不佳会影响继发性肺动脉高压的数值和可逆性。基于平川的方法,对34例单纯二尖瓣狭窄(SM)患者计算PVcomp(= 0.4''×SV/V - d)。根据PVcomp的平均值,将该组分为顺应性差(<= 4.3 ml/mmHg)和顺应性好(4.4 ml/mmHg及以上)两组。在二尖瓣置换术(MVR)前,两组在静息时评估的PAP、PWP、SVI、PVR值无差异。在仰卧位运动(25瓦)期间,顺应性差的患者观察到PAP和PWP值显著更高。MVR后6个月,所有患者的PAP和PWP值均恢复正常。初始PVcomp值良好的患者中,SVI值显著更高,PVR降低。在运动(25瓦)期间,初始PVcomp值差的患者中PAP和PVR值显著更高。肺静脉顺应性可能是影响二尖瓣置换术后6个月临床结局的独立因素。

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