"肺性P''と肺性肺高血圧ならびに肺循環諸量との関連について

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So-called pulmonary P has been described ,and discussed by many investigators, but as to criteria of pulmonary P, there are still some different opinions. The purpose of this study was to investigate the relationship between the magnitude of the P waves and the disturbances of the pulmonary hemodynamics, especially pulmonary hypertension, in patients with chronic pulmonary diseases. Material and Method : Ninety patients with chronic pulmonary disease (62 cases with pulmonary emphysema, 12 with bronchial asthma, 3 with silicosis, 3 with bronchiectasis, 2 with pulmonary tuberculosis, 2 with lung tumor, 2 with pulmonary fibrosis, one with primary pulmonary hypertension, one with pyothorax, one with chronic bronchitis, and one with pulmonary sarcoidosis) were studied. Electrocardiograms of routine 12 leads were recorded just before the right heart catheterization. Results : The incidence of P waves with heights of above 0.2 mV in all of leads II, 111, and a_V_F increased with elevating pulmonary artery mean pressure (PAm). However, such P waves were observed in 12.5 per cent of cases without pulmonary hypertension. When P waves were 0.25 mV or more in lead II and above 0.2 mV in leads III and a_V_F, such a'. combination of P waves was more closely correlated with PAm than the other type of P waves, and was defined as "pulmonary P" in this study. It was found that 60 per cent of cases with PAm over 30 mmHg, 25 per cent of cases with PAm of from 20 to 29 mmHg, 10 per cent of cases with PAm of from 17 to 19 mmHg, and none of cases with PAm below 16 mmHg showed this pulmonary P. Among the cases who had the pulmonary P, PAm was measured in 1 5 cases, right ventricular systolic pressure (RVs) in 10, right ventricular end-diastolic pressure (RVd) in 6, right atrial mean pressure (RA) in 7, pulmo-nary vascular resistance index (PVRI) in 1 1, total pulmonary resistance index (TPRI) in 9, and the average values of these were 30.2 mmHg, 41.8 mmHg, 6.0 mmHg, 3.4 mmHg. 488.1 dynes, sec, cm<-5>/M2, and 743.0 dynes, sec, cm<-5>/M2 respectively. On the other hand, among the cases who did not have the pulmonary P, PAm was measured in 75 cases, RVs in 43, RVd in 48, RA in 33, PVRI in 46, and TPRI in 46, and the average values of these were 19.1 mmHg, 27.1 mmHg, 3.9mmHg, 2.5mmHg, 285.3 dynes, sec, cm~5<ookikutsur ^<-5>M^2, and 440.6 dynes, sec, cm^-5/M^2 respectively.
社団法人日本循環器学会の論文
1967-02-20

"肺性P''と肺性肺高血圧ならびに肺循環諸量との関連について

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