Left Ventricular Ejection Performance in Heart Failure. : Assessment by Angiotensin II Loading and Follow-up Echocardiographic Studies

概要

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To elucidate the left ventricular ejection performance in patients with heart failure by chages in afterload stress, 14 patients with dilated cardiomyorathy were subjected. 1. Angiotensin II (AT II) loading test: Left ventricular end-systolic wall stress (WS), the time velocity integrals of left ventricular total filling (IT) and left ventricular forward ejection flow (IE), and their ratio (IE/IT) were measured by M-mode and Doppler echocardiography. Patients were given AT E intravenously and re-examined by echocardiography. The severity of mitral regurgitation by color Doppler (MR) was also assessed; 2. Follow-up study: The same echocardiographic variables were obtained before and after medical treatment (mean 6.1 months). Results: 1: By AT II, WS increased significantly, while, IE, IT, and IE/IT (an index of left ventricular ejection efficacy) decreased significantly (p<0.01). 2: By medical treatment, all patients had symptomatic improvement. During the follow-up period, WS reduced significantly, IE and IE/IT increased significantly (p<0.01). IT tended to increase and MR reduced significantly (p<0.01) during the follow-up period. In conclusion: Not only the depressed systolic funtion (afterload mismatch) but also the decreased left ventricular ejection efficacy due to enhanced MR plays an important role in the decrement of left vantricular forward ejection by increased afterload stress.
神戸大学の論文
1996-01-31