NON-INVASIVE ASSESSMENT OF THE PERFORMANCE OF THE RIGHT HEART DURING DYNAMIC EXERCISE, A STUDY OF LEFT-SIDED HEART DISEASE

概要

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A simplified, non-invasive method for assessment of the performance of the right heart during supine leg exercise was described, which necessitated no more than a bicycle"ergometer"for leg exercise, a radiocardiograph for recording cardiac index (CI) and a"water"manometer for measuring cubital venous pressure (VP). Because the use of a cardiac catheter was omitted, right atrial pressure (RA), right ventricular diastolic pressure (RV_d) or pulmonary arterial pressure (PA) were not measured. In 11 healthy subjects and 25 patients with primarily left-sided valvular disease and hypertension, the observed shift of CI-VP plot with exercise was similar to the published records of exercise-induced shift of CI-RA plot or CI-RV_d plot in normal subjects and the same types of heart disease. With levels of load used in this study, a dividing line separating normal from abnormal elevation of VP during supine leg exercise (ΔVP) could be drawn at ΔVP=35 mm H_2O and (2) in these types of heart disease, ΔVP in excess of 35 mm H_2O was always associated with a"subnormal"increase in CI (ΔCI < 0.8 lit. min^<-1>. M^<-2>) with exercise, except in a few cases who appeared, clinically, to be in what may be termed"latent heart failure". Factors probably responsible for an impaired pumping ability of the right heart during exercise in left-sided heart disease were discussed, in relation to ΔVP.
社団法人日本循環器学会の論文
1976-02-20