Valsalva 試験の慢性呼吸器疾患患者心電図に及ぼす影響とその臨床的意義に関する研究
スポンサーリンク
概要
- 論文の詳細を見る
There have been already many investigations on the circulatory effects of Valsalva maneuver, and especially with regard to the change of pulmonary circulation it has been made clear that the venous return to right heart during straining is blocked by the increased intrathoracic pressure, and then by the sudden fall of the intrathoracic pressure after release of straining the blood remaining stagnant in the face and extremities suddenly flows into the right heart and the stroke volume of the right ventricle increases compared with that at rest and there is a transient rise of the pulmonary arterial pressure and the net pulmonary capillary pressure. The purpose of this report is to present the electrocardiographic changes by the Valsalva maneuver in patients of chronic broncho-pulmonary diseases in an attempt to detect any specific electrocardiographic changes in pulmonary hypertension or latent cor pulmonale and to discuss their clinical significance. Materials and Methods: (1) One hundred and eleven cases have been chosen for this study, including 76 cases of chronic respiratory diseases, 15 cases of non-cardiopulmonary diseases, 5 cases of neurocirculatory asthenia and 15 cases of healthy adults. The 76 cases of respiratory diseases consists of 35 cases of pulmonary tuberculosis (including 12 cases of after operation and 6 cases of severe pleural involvement), 10 cases of pulmonary emphysema, 8 cases of bronchiectasis, 20 cases of chronic bronchitis and bronchial asthma and 3 cases of lung tumor. (2) First the routine electrocardiogram at rest was recorded, and then, during and following the Valsalva maneuver at lead I, II, III, V_1 and V_5. The Valsalva maneuver was performed by having each subject maintained an expiratory pressure of at least 40mm.Hg for about 10 seconds by blowing into a aneroid sphygmomanometer. Next, of 20 cases including 10 cases taken at random out of the patients of severe broncho-pulmonary diseases and another 10 cases of healthy adults and in-patients without cardiopulmonary diseases, the author recorded their electrocardiogram at rest and following Valsalva maneuver at a speed of 50mm per second, photographically enlarged it, and observed the changes in the ventricular activation time and QRS amplitude at V_1, studying the measured values of both groups in comparison. The respiratory function was judged from the ventilatory function measured with a 9.0 L or 13.5 L Bendict-Roth type respirometer.
- 社団法人日本循環器学会の論文
- 1966-12-20