心・脈管力学値とベクトル分析値との相関

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The cardiovascular dynamical analysis occasionally enables one to deduce the nature of the lesions by an understanding of the electrocardiogram, therefore, the hemodynamics studied by newly improved Wezler's and Blumberger-Holldack's methods was contrasted with mean values of fromtal vector and ventricular gradient regarding 181 cases in total made up as follows, normal health 44, arterial hypertension 69, valvular disorders 28, congestive heart failure 15, and coronary diseases 25. 1. About 44 cases, both female and male, without any recognizable cardio-circulatory disorders, the values of vector were determined in the steady state. The age ranged from in their teen to in their sixties. These values.almost coincided with those reported by predecessors. 2. Arterial hypertension a. In the marked systolic hypertension, ΔαG, ΔαGT and G/R tend to shift while in the distinct diastolic hypertension the deviation of vector, as a rule, increases in frequency. b. There exists no direct correlation between retinal findings and values of vector. c. As to the relationship between circulatory dynamics and values of vector, in minute volume (M) type G_J^^^∧ has a tendency to become smaller, ΔαG to deviate negatively while in resistance (W) type G_J^^^∧ is liable to remain unchanged, ΔαG to shift positively. d. Concerning the relationship between age and values of vector, it is safe to say that T_J^^^∧ and G_J^^^∧ are prone to be amaller according to the juvenile while αQRS is ready to be more of left type corresponding the senile. e. From the results observed upon the cerebro-cardio-renal complication and the renal hypertension, it may be concluded that in the cardiac involvement the deviation of vector is possible to be frequently found, especially G/R is apt to become smaller.f. When subjective and objective states are improved by means of treatment of high blood pressure, the abnormal shifting or the advanced deviation increases in its frequency in accordance with the severity of Keith-Wagener's classification. The medication of 1-Hydrazinophthalazine reduces peripheral and elastic resistance, slightly augments minute volume, whereas T_J^^^∧, G_J^^^∧ and G/R increase in their amount. The use of Rauwolfia serpentina does not so markedly modify peripheral and elastic resistance, yet normalizes minute volume while QRS_J^^^∧, T_J^^^∧, G_J^^^∧ and G/R are augmented, ΔαG is normalized. By administration of ganglionic blocking depressants, minute volume remains almost unvaried, peripheral and elastic resistance lessen to some degree, whereas QRS_J^^^∧, T_J^^^∧ and G_J^^^∧ are decreased in their amount. Adrenolyticum augments T_J^^^∧ but blood pressure level and circulatory dynamics do not always show variations in the same meaning. 3. Valvular disorders. Generally in the cases characterized with intense left ventricular load ΔαG tends to shift negatively, while in right ventricular load it does positively. The decompensated cases show the deviation of ΔαG, ΔαT and G/R. 4. Cardiac insufficiency. As a rule, among various sorts of disorders the improvement of decompensation reduces the rightsided deviation of αG and normalizes ΔαG. Digitalis and its preparates have a tendency to diminish G_J^^^∧, even if there is found no significant difference between the kinds of preparates effective for the remedy of the decompensation. Commissurotomy of mitral stenosis is proved to disload the burden of pulmonary circulation and to ameriolate the left ventricular filling from hemodynamical viewpoint, while there can be reformed the values of vector respectively. 5. Coronery disorders. In the cases with myocardial infarction, QRS_J^^^∧ and G_J are commonly small, and the deviation of their direction becomes more marked.In patients suffered from anginal pain, QRS_J^^^∧ is larger, G_J^^^∧ small, so that G/R is minimized. In the cases without anginal pain but with coronary electrocardiogram, QRS_J^^^∧ is small, αQRS shifts negatively, and the deviation of. ΔαG is large. In the patient with positive anoxic test, the deviation of values of vector, especially, ΔαG, ΔαT, G_J^^^∧ and G/R show abnormalities, but on the other hand, in the cases without marked changes of values of vector, there exists also hemodynamically no evil symptom. In the patients whose subjective and objective conditions are made better by means of the treatment, the increase in G_J^^^∧ can be found. Usually, during merely short term of observation, αG and ΔαG exhibit no significant variations in the cases with organic lesions.
千葉大学の論文
1958-05-28

心・脈管力学値とベクトル分析値との相関

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