<原著>右室負荷疾患における左室収縮および拡張機能障害

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To clarify the mechanism of impaired left ventricular (LV) function induced by right ventricular overload (RVO), we studied 74 patients, consisting of 55 with atrial septal defect, 10 with primary pulmonary hypertension, and 9 with other disorders, using 2-D echocardiography and pulsed Doppler method. Patients were divided into 3 groups, as follows : those with pressure overload (P group), pressure-volume overload (VP group) and volume overload (V group). Sixteen healthy subjects were studied as controls (N group). LV distortion score (A/B) was calculated as the ratio of the largest LV anterior-posterior diameter (A) to the largest septal-lateral diameter (B) which crosses it at right angles. A/B was determined at end-systole (ES), early-diastole (EaD), and end-diastole (ED). A/B was increased in patients with RVO ; the mean value at ES was 1.09±0.08 in N group, 1.75±0.82 in P group, 1.65±0.54 in VP group, 1.20±0.11 in V group. A/B value at ES was positively correlated (r=0.787,p<0.01) with systolic pressure gradient through the tricuspid valve. Peak flow velocity (R) in LV rapid filling and LV fractional area shortening (FAS) were decreased in patients with RVO. Pre-ejection period (PEP) was prolonged, ejection time (ET) shortened, and PEP/ET ratio increased in patients with RVO. Systolic wall thickening (△C) of ventricular septum was decreased in patients with RVO, especially in P group. A/B at ES was inversely correlated with R(r=-0.367. p<0.01) and △C(r=-0.337 : p<0.01). These abnormalities of LV systolic and diastolic functions were correlated with the degree of distortion of LV cavity. In conclusion, there are obvious impairments of LV function in patients with RVO, and these may be due to geometric distortion of the LV cavity.
近畿大学の論文
1992-09-25

<原著>右室負荷疾患における左室収縮および拡張機能障害

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