Spes C H, Schnaack S D, Theisen K, Angermann C E
Medizinische Klinik, Klinikum Innenstadt, Ludwig-Maximilians-Universität München, Germany.
Z Kardiol. 1993 May;82(5):324-31.
Orthotopic heart transplantation results in altered atrial anatomy and denervation of the donor heart. To assess the impact of these sequelae on left ventricular filling and systolic performance, 16 heart transplant recipients and 10 normal controls were evaluated by Doppler echocardiography at rest and during graded bicycle exercise. Global and regional systolic ventricular allograft function was normal at rest and during exercise. Resting Doppler profiles demonstrated diminished atrial contribution to ventricular filling in transplant recipients. The response to dynamic exercise was different in both groups; controls increased heart rate, while mitral time-velocity integral was unchanged. Heart transplant recipients, in contrast, showed a blunted heart rate response and increased time-velocity integral. Atrial contribution to ventricular filling was not augmented during exercise as in normal controls. Alterations in transmitral flow profiles in heart transplant recipients do not necessarily reflect ventricular myocardial damage, but may be related to impaired atrial function.
原位心脏移植会导致心房解剖结构改变以及供体心脏去神经支配。为评估这些后遗症对左心室充盈和收缩功能的影响，对16名心脏移植受者和10名正常对照者在静息状态和分级自行车运动期间进行了多普勒超声心动图评估。移植心脏的整体和局部收缩功能在静息和运动时均正常。静息时的多普勒血流图显示移植受者心房对心室充盈的贡献减少。两组对动态运动的反应不同；对照组心率增加，而二尖瓣时间-速度积分不变。相比之下，心脏移植受者心率反应迟钝，时间-速度积分增加。运动期间心房对心室充盈的贡献不像正常对照者那样增加。心脏移植受者二尖瓣血流图的改变不一定反映心室心肌损伤，而可能与心房功能受损有关。
