Hemodynamic Effects of Positive end-expiratory Pressure on Right Ventricular Diastolic Function in Patients with Acute Myocardial Infarction
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概要
- 論文の詳細を見る
The effects of positive end-expiratory pressure (PEEP) on the right ventricular (RV) diastolic function in patients with congestive heart failure (CHF) due to acute myocardial infarction (AMI) are unknown. The aim in this study was to investigate PEEP associated variations in RV diastolic function in CHF due to AMI. The subjects comprised the control group (26 subjects) and the AMI group (36 subjects) classified as 20 patients with pulmonary capillary wedge pressure (PCWP) < 18 mmHg (CHF-low PCWP group) and 16 patients with PCWP≧18mmHg (CHF-high PCWP group). PEEP was applied for 30 minutes at 0, 5, 10 and 15 cmH_20. Two-dimensional echocardiography with continuous and pulse wave Doppler studies was performed. RV diastolic functional parameters included the ratio of peak early tricuspid valve filling and peak atrial filling velocities, the decelation time of the tricuspid E valve and the RV isovolumic relaxation time. In the control and CHF-low PCWP groups, right atrial pressure, mean pulmonary arterial pressure (mPAP), total pulmonary resistance (TPR) and systemic vascular resistance (SVR) increased, output (CO) decreased and RV diastolic functional parameters worsened significantly at the transition from 10 to 15 cmH_20 PEEP. In the CHF-high PCWP group, mPAP, TPR and SVR decreased, while CO increased and RV diastolic functional parameters improved significantly at the transition from 10 to 15 cmH_20 PEEP. From these findings, it is clear that PEEP induced hemodynamic deterioration and reduces RV diastolic function in intact and mildly failing hearts. On the other hand, in severely failing hearts, PEEP effers hemodynamic improvement and ameliorates RV diastolic function. It appears possible to predict responses to PEEP by determining RV diastolic function in CHF. Therefore, we conclude that evaluation of the RV diastolic function during PEEP is highly important in terms of recognizing the effectiveness of PEEP therapy in CHF.
- 獨協医科大学の論文
- 2004-07-25
著者
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Kaneko Noboru
Department of Pneumology and Cardiology, Dokkyo Medical University School of Medicine
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Taguchi Isao
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Abe Shichiro
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Kaneko Noboru
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Nakamoto Takaaki
Department Of Pneumology And Cardiology Dokkyo Medical University School Of Medicine
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Kuga Hideyo
Departments Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Taguchi Isao
Department Of Cardiology And Pneumology Dokkyo Medical University School Of Medicine
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Taguchi I
Shimane Medical Univ. Izumo Jpn
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Kaneko Noboru
Department Of Clinical Laboratory Medicine Dokkyo University School Of Medicine
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Kaneko Noboru
Department Of Cardiology And Pneumology Dokkyo Medical University School Of Medicine
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Kaneko Noboru
Department Of Cardiology And Pneumology Dokkyo Medical University
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Hasumi Hisashi
Department Of Cardiology And Pneumology Dokkyo Medical University
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Suzuki Hidehiko
Department Of Pneumology And Cardiology Dokkyo Medical University School Of Medicine
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Suzuki Hidehiko
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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FUSE Daisuke
Department of Cardiology and Pneumology, Dokkyo University School of Medicine, Tochigi Prefecture
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Horie Yasuto
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Harasawa Hiroshi
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Susuki Hidehiko
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Hoshi Toshiyasu
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Sugimura Hiroyuki
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Amano Hiroshi
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Kaneko Noboru
Department Of Pneumology And Cardiology Dokkyo Medical University School Of Medicine
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Kaneko Noboru
Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical College
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Amano Hirohisa
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Nakamoto Takaaki
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Fuse Daisuke
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Horie Yasuto
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Abe Shichirou
Department Of Cardiology And Pneumology Dokkyo Medical University School Of Medicine
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Harasawa Hiroshi
Department Of Cardiology And Pneumology Dokkyo Medical University
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Hoshi Toshiyasu
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Sugimura Hiroyuki
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Kaneko Noboru
Heart Institute Of Japan Tokyo Women's Medical College
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Sugimura Hiroyuki
Department Of Cardiology & Vascular Disease Dokkyo Medical University Nikko Medical Center
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Kaneko Noboru
Dept.of Cardiology Tokyo Women's Medical College
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Harasawa Hiroshi
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Abe Shichiro
Department Of Cardiology And Pneumology Dokkyo University School Of Medicine
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Fuse Daisuke
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Kaneko Noboru
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
-
Nakamoto Takaaki
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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Abe Shichiro
Department of Cardiology and Pneumology Dokkyo Medical University School of Medicine
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Kuga Hideyo
Department of Cardiology and Pneumology, Dokkyo University School of Medicine
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