Left Atrial Function Preserves Pulmonary Circulatory Pressure During Pacing-Tachycardia and Contributes to Exercise Capacity in Patients With Idiopathic Dilated Cardiomyopathy in Sinus Rhythm, Whose Exercise is Limited by Dyspnea
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概要
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The aim of this study was to determine whether left atrial (LA) function contributes to pulmonary circulatory pressure during pacing-tachycardia and exercise capacity in patients with idiopathic dilated cardiomyopathy (DCM). Thirty-two patients with DCM and in sinus rhythm had limited exercise capacity because of dyspnea. The correlation between peak oxygen consumption (VO_2) and the variables of cardiac function by cardiac catheterization and 2-dimensional, Doppler echocardiography, and plasma neurohumoral factor levels was tested, as was the correlation between non-invasive LA functional parameters and pulmonary circulatory pressure during pacing-tachycardia. A significant correlation was observed between VO_2 and LA dimension (r=-0.45, p<0.01), the peak velocities of LA appendage empty flow during atrial systole (r=0.63, p<0.0001) and the pulmonary venous forward flow in early ventricular systole (PVSl; r=0.74, p<0.0001), as well as plasma brain natriuretic peptide (BNP) concentrations. The predictable equation to VO_2 with the multiple regression analysis was VO_2=-0.01 BNP+0.21 PVSl+15.4 (r=0.81, p<0.0001). Furthermore, LA functional variables derived from pulmonary venous flow, especially PVS 1, but not plasma BNP concentration, were useful for predicting the degree of the increase in pulmonary circulatory pressure during pacing-tachycardia. Therefore, it is suggested that LA function contributes to exercise capacity through its influence on pulmonary hemodynamic reserve in patients with DCM with sinus rhythm whose exercise is limited by dyspnea. (Circ J 2002; 66: 937-942)
- 社団法人日本循環器学会の論文
- 2002-09-20
著者
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KOMAMURA Kazuo
Division of Cardiology, National Cardiovascular Center
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Miyatake Kunio
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
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MASUYAMA Tohru
Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine
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Sasaki Tatsuya
Division of Cardiology, Sakurabashi Watanabe Hospital
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Sasaki Tatsuya
Division Of Cardiology Osaka Koseinenkin Hospital
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Masuyama Tohru
Department Of Internal Medicine And Therapeutics Osaka University Graduate School Of Medicine
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Kubo Takashi
Division of Cardiovascular Medicine, National Cardiovascular Center
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Miyamoto Tetsuya
Division of Cardiovascular Medicine, National Cardiovascular Center
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Honda Kaduo
Division of Cardiology, Department of Cardiology and Cardiovascular Surgery, Osaka Kosei-nenkin Hosp
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Honda Kaduo
Division Of Cardiology Department Of Cardiology And Cardiovascular Surgery Osaka Kosei-nenkin Hospit
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Miyamoto Tetsuya
Division Of Cardiology Kurume University Medical Center
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Miyatake Kunio
Division Of Cardiology Department Of Medicine National Cardiovascular Center
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Honda Kaduo
Division Of Cardiology Department Of Cardiology And Cardiovascular Surgery Osaka Kosei-nenkin Hospit
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Kubo Takashi
Division Of Cardiovascular Medicine National Cardiovascular Center
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Komamura Kazuo
Division Of Cardiology National Cardiovascular Center
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Sasaki Tatsuya
Division Of Cardiology Department Of Cardiology And Cardiovascular Surgery Osaka Kosei-nenkin Hospit
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Komamura Kazuo
Division of Cardiovascular Medicine, National Cardiovascular Center
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Miyatake Kunio
Division of Cardiovascular Medicine, National Cardiovascular Center
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