Kisanuki A, Murayama T, Matsushita R, Otsuji Y, Toyonaga K, Miyazono Y, Arima S, Nakao S, Taira A, Tanaka H
First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Am Heart J. 1996 Jan;131(1):101-6. doi: 10.1016/s0002-8703(96)90057-5.
Assessment of systolic and diastolic coronary blood flow velocities (FVs) in patients with aortic regurgitation (AR) has remained a clinical challenge. We recorded left anterior descending coronary blood FV in 21 patients with chronic AR an in 6 control subjects using transesophageal pulsed Doppler echocardiography. In 7 patients FV was measured 4.0 +/- 5.2 months after aortic valve replacement. Peak and mean FVs during systole and diastole and systolic/diastolic ratios of these FVs were determined. Left ventricular (LV) mass index was calculated by means of standard M-mode echocardiography. In patients with severe AR, peak and mean systolic FVs were significantly increased (34 +/- 8 cm/sec and 21 +/- 6 cm/sec, respectively) compared with FVs in the control group (15 +/- 4 and 12 +/- 3 cm/sec, respectively) and in patients with mild AR (17 +/- 3 cm/sec and 13 +/- 2 cm/sec, respectively). Peak and mean systolic FVs were also significantly increased in severe AR (54 +/- 13 cm/sec and 33 +/- 9 cm/sec, respectively) compared with FVs in the control (30 +/- 8 cm/sec and 21 +/- 5 cm/sec, respectively) and mild AR groups (30 +/- 5 cm/sec and 21 +/- 4 cm/sec, respectively). Peak systolic and diastolic FVs were correlated significantly with LV mass index (r = 0.72 and r = 0.73, respectively). Systolic and diastolic FVs and LV mass index were significantly decreased, normalized or both after aortic valve surgery. In conclusion, LV mass seems to have an effect on the significantly increased systolic and diastolic left coronary blood FV pattern in patients with chronic, severe AR. Increased systolic and diastolic FV appears to be normalized in the late period after surgery.
评估主动脉瓣反流（AR）患者的收缩期和舒张期冠状动脉血流速度（FV）一直是一项临床挑战。我们使用经食管脉冲多普勒超声心动图记录了21例慢性AR患者和6例对照者的左前降支冠状动脉血流FV。7例患者在主动脉瓣置换术后4.0±5.2个月测量了FV。测定了收缩期和舒张期的峰值FV和平均FV以及这些FV的收缩期/舒张期比值。通过标准M型超声心动图计算左心室（LV）质量指数。与对照组（分别为15±4 cm/秒和12±3 cm/秒）和轻度AR患者（分别为17±3 cm/秒和13±2 cm/秒）相比，重度AR患者的收缩期峰值FV和平均FV显著增加（分别为34±8 cm/秒和21±6 cm/秒）。与对照组（分别为30±8 cm/秒和21±5 cm/秒）和轻度AR组（分别为30±5 cm/秒和21±4 cm/秒）相比，重度AR患者的收缩期峰值FV和平均FV也显著增加（分别为54±13 cm/秒和33±9 cm/秒）。收缩期和舒张期峰值FV与LV质量指数显著相关（分别为r = 0.72和r = 0.73）。主动脉瓣手术后，收缩期和舒张期FV以及LV质量指数显著降低、恢复正常或两者兼有。总之，LV质量似乎对慢性重度AR患者显著增加的收缩期和舒张期左冠状动脉血流FV模式有影响。术后晚期收缩期和舒张期FV增加似乎恢复正常。
