Satoh A, Katayama K, Hiro T, Yano M, Miura T, Kohno M, Fujii T, Matsuzaki M
Second Department of Internal Medicine, Yamaguchi University, School of Medicine, Japan.
Jpn Circ J. 1996 Oct;60(10):758-66. doi: 10.1253/jcj.60.758.
This study was undertaken to investigate the effect of chronic right ventricular (RV) volume overload on left ventricular (LV) diastolic function. Twelve patients with atrial septal defect and 7 age-matched normal controls were examined. Patients with atrial septal defect were divided into 2 groups based on their Qp/Qs values (ASD1:Qp/Qs < or = 3, n = 7; ASD2:Qp/Qs > 3, n = 5). The LV volume curve and its first derivative were derived by a frame-by-frame analysis of the left ventriculogram. The peak filling rate was defined by the peak positive first derivative of the LV volume curve. We measured the time constant, isovolumetric relaxation time, stiffness constant and compliance at LV end-diastole. The time constant was significantly prolonged in the ASD2 group compared with the controls, and the isovolumetric relaxation time in both atrial septal defect groups was also prolonged compared with the controls. The peak filling rate, which was normalized by end-diastolic volume, was lower in the ASD2 group than in the controls. Although the stiffness constant and the compliance at LV end-diastole in the controls were not significantly different from those in the atrial septal defect group, an upward and leftward displacement of the left ventricular pressure-volume curve was observed in patients with atrial septal defect. Moreover, a significant correlation (r = 0.78, p < 0.01) was observed between the time constant and RV end-diastolic pressure. Thus, these results suggest that chronic RV volume overload affects left ventricular diastolic function.
本研究旨在探讨慢性右心室（RV）容量负荷过重对左心室（LV）舒张功能的影响。对12例房间隔缺损患者和7例年龄匹配的正常对照者进行了检查。房间隔缺损患者根据其Qp/Qs值分为2组（ASD1：Qp/Qs≤3，n = 7；ASD2：Qp/Qs＞3，n = 5）。通过对左心室造影片逐帧分析得出左心室容量曲线及其一阶导数。峰值充盈率由左心室容量曲线的正一阶导数峰值定义。我们测量了时间常数、等容舒张时间、僵硬度常数和左心室舒张末期顺应性。与对照组相比，ASD2组的时间常数显著延长，两个房间隔缺损组的等容舒张时间也比对照组延长。以舒张末期容量标准化的峰值充盈率，ASD2组低于对照组。虽然对照组与房间隔缺损组左心室舒张末期的僵硬度常数和顺应性无显著差异，但房间隔缺损患者的左心室压力-容量曲线向上和向左移位。此外，时间常数与右心室舒张末期压力之间存在显著相关性（r = 0.78，p＜0.01）。因此，这些结果表明慢性右心室容量负荷过重会影响左心室舒张功能。
