運動負荷の血行力学的効果に関する研究

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概要

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• Hemodynamic responce to physical excercise has been studied in various diseased status and the response has been compared to those of normal control group. It is also the purpose of this study to make comparative evaluation of the hemodynamic response to excercise between the group of patients with stenosis of mitral or pulmonic valvular orifice and the group of patients with atrial septal defect or normal healthy subjects, in which excercise response was expressed as a ratio of increase in cardiac output to increase in oxygen consumption per unit of time. Methods ; 3 healthy normal subjects, 7 cases of mitral stenosis, 5 cases of pulmonic stenosis and 4 cases of atrial septal defect were chosen for this study. All the mitral stenosis and pulmonic stenosis cases were of milder condition and presented no clinical symptoms in their routine daily life. Right heart catheterization was performed according to the COURNAND'S method at rest and after measurements of cardiac output and pulmonary arterial pressure, patients were put on leg exercise and the measurements were repeated during the fifth minutes excercise. Cardiac output was measured from arterio-venous oxygen difference and oxygen consumption per minute using the FICK's formula. Results ; In the normal control group, restring cardiac index was ranged between 4.80 and 5.39 l/min./M^2, and the response index to excercise, as a ratio of increase in cardiac output in ml/increase in oxygen uptake in hundred ml was ranged between 800 and 900 ml/min.. Pulmonary arterial pressure went up less than 5 mmHg over the control pressure value. In mitral stenosis group, cardiac index was ranged between 2.13 and 4.40 ml/ min./M^2 and the ratio of increase in cardiac output to increase in oxygen consumption during excercise was less than 800 ml/min. with one exception, which showed 943 ml/min.. In all the cases of this group, significant elevation of pulmonary arterial and wedge pressure were observed during exercise. In the pulmonic stenosis group, exercise index was less than 800 ml/min. in 3 cases. In the ASD group, all 4 cases have shown definitely greater value of exercise index exceeding 1000 ml/min. Conclusion ; Even in clinically silent cases of mitral stenosis or pulmonic stenosis, hemodynamic response to exercise indicated as a ratio of increase in cardiac output to in-crease in oxygen uptake is significantly less than 800 ml/min., contrasting to the data obtained in the group of ASD patients presented exceedingly greater value of normal range between 800 and 900 ml/min.

• 社団法人日本循環器学会の論文
• 1966-09-20

著者

• 高木 堅

  上野市民病院内科

• 高木 堅

  三重県立大高崎内科

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• 運動負荷の血行力学的効果に関する研究

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