右室の駆出期時間並びに機械効果に及ぼす肺動脈昇圧の影響に関する臨床病態生理学的研究 : 第1編 肺動脈圧と右室の駆出期時間との関係

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概要

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• Responses of the pulmonary circulation and the respiratory functions on exercise in normal subjects, patients with chronic cardiac disease and patients with chronic pulmonary disease were studied. Materials and Methods In 4 normal subjects, 30 patients with chronic cardiac disease (21 with mitral valvular disease and 9 other cases), and 36 patients with chronic pulmonary disease ( 19 with emphysema and 17 other cases), right heart catheterization were performed, and all subjects had a mild leg exercise for five minutes in supine position. Pulmonary hemodynamics and respiratory functions were observed in steady state at rest and on exercise. In normal subjects the increment of cardiac output (CO) was over 800 cc/min/M^2 per 100 cc/min of increase of oxygen consumption in all subjects. In cardiac patients, 7 cases (23%) showed the increment of CO above 800 cc/min/ M^2 (Group 1), 18 cases (60%) had the increment below 800 cc/min/M^2 (Group 2), and 5 cases (17%) showed a decrement (Group 3). In pulmonary patients, 16 cases (44% ) showed the increment of Group 1, 1 7 cases (47%) had the increment of Group 2, and 3 cases (9%) showed a decrement (Group 3). Results 1) Cardiac index (CI) On the exercise, the average increase of cardiac index was 44 per cent in normal subjects. In cardiac patients, it was 17 per cent. In Group 1 the average increase was 44 per cent, in Group 2 it was 16 per cent, and in Group 3 it was 9 per cent. In pulmonary patients, the average increase of CI was 33 per cent. In Group 1 the average increase was 56 per cent, in Group 2 it was 2 7 per cent, and in Group 3 it was 20 per cent. 2) Pulmonary artery wedge pressure (WP) On the exercise, in the most cardiac patients WE elevated significantly and was within a range of -5 to + 18 (average '+6.0) mmHg. The average elevation of WP was 6.1 mmHg for Group 1, + 4.2 mmHg for Group 2, and 10.2 mmHg for Group 3 respectively. In pulmomary patients there were no significant changes of WP on exercise except one, and the change was within a range of -3 to +6 (average + 1.9) mmHg.

• 1965-12-20

著者

• 渡辺 信治

  大阪医大原内科

• 渡辺 信治

  大阪医科大学大学院医学研究科内科学

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