健常,および,病態における心・脈管力学,とくに, Blumberger-Holldack法,ならびにWezler法による研究について
スポンサーリンク
概要
- 論文の詳細を見る
Haemodynamically by means of Blumberger-Holldack's and newly improved Wezler's, methods, 111 observations were made upon 38 normal health and 43 patients suffered from various kinds of cardiovascular diseases inclusive of one case with WPW symptom complex; in a certain circle of cases there came simultaneously into use cardiac and coronary sinus catheterizations. 1. At the estimation of cardiovascular dynamics, the special attention was always paid to the respiratory state registered by my collaborators at the same time. 2. Cardiovascular dynamics of the auricular fibrillation. The availability of both frustrated auricular contractions and irregular heart beats recorded sufficiently long, makes it easy to investigate the correlation between cardiovascular dynamics of each heart systole and preceding" cardiac period or diastolic length. Stroke volume and left cardiac work increase, to some degree, running roughly parallel to the preceding cardiac period or diastolic length; although plottings are pretty widely scattered, one curve suggestive of a Starling's schema can be obtained as "preceding cardiac period-, or diastolic length-stroke volume curve". Within a certain limit, systolic pressure tends to rise, diastolic to lower, and pulse pressure to increase depending upon the augmented length of preceding cardiac period. Cardiodynamically in accordance with the increase in preceding cardiac period or diastolic length, "Umformungszeit" (U. F. Z.) is predisposed to decrease or to remain unchanged, whereas "Druckanstiegszeit" (D. A. Z.) becomes shorter, consequently "Anspannungszeit" (A.. S. Z.) is reduced. "Austreibungszeit" (A. T. Z.) is apt to be prolonged further ("preceding cardiac period-, or diastolic length-cardiac dynamics curve"). QII sound interval is determined with the degree of in- or decrease in A.S.Z. and A.T.Z. A.T.Z. : A.S.Z. becomes larger. These tendencies are possible to recognize also in auriculai fibrillation complicated with valvular heart diseases. 3. Influence of digitalization upon cardiovascular dynamics. In the cases with auricular fibrillation the effective digitalization abolishes the clinical symptoms and-elevates "preceding diastolic length-stroke volume curve" right or right upwards. In "preceding diastolic length-cardiac dynamics curve", U.F.Z., D.A.Z. and A.S.Z. are prone to be shortened or to remain unchanged; A.T.Z. is commonly not prolonged in spite of augmented stroke volume. Thus, the cardiovascular dynamics recovers correspondingly to the primary state of underlying diseases. In the digitalisrefractory cases, those two curves do hardly shift or show any marked variation and occasionally display even the reversal tendency notwithstanding digitalization. Utilizing those two curves, in auricular fibrillation, the effects of various digitalis preparates, especially, both potency and velocity of their cardiac actions can be investigated. In this manner, it is possible to understand the heart rates most suitable for the cardiovascular dynamics and to control the auricular fibrillation. Besides auricular fibrillation, in various sorts of arrhythmias the heart rates appropriate to maintain the compensatory dynamics can be calculated. 4. According to the prematurity of extrasystoles, the ventricular filling is reduced. D.A.Z. and A.S.Z. of extrasystoles are longer than those of basal beats, consequently A.T.Z. is shortened. A.T.Z.: A.S.Z. is minimized. In the first postextrasystolic normal beat, besides the increase in ventricular filling, owing to the decrease in stroke volume of extrasystoles and the increase in preceding diastole, the presystolic intraaortic pressure diminishes, in such way the cardiovascular dynamics of extrasystoles is found in contrast with that of basal beats. 5. It happened to be able to observe the cardiovascular dynamics of one case who showed the reversible shifting between WPW symptom complex and normal beats at the very time of the registration. The difference of both cardiac rates and blood pressure levels in two rhythms fluctuated within 10% in this patient without any organic heart disease. Except for the paroxysmal tachycardia, there was seen actually no discrepancy in the cardiovascular dynamics of these two rhythms. In this examination, instead of U. F. Z., δa-I sound time (from the initiation of δ weve) and δe-I sound time (from the finish of δ wave) were measured respectively. 6. In order to clarify the influence of extracardiac factors upon cardiovascular dynamics, Aschner's test, intravenous injection of epinephrine and exercise test were adopted. 7. In a patient suffered from mitral stenosis, before and after the commissurotomy, there was studied the effect of altered mechanical energy elicited in myocardium upon cardiovascular dynamics. 8. The cardiovascular dynamics was investigated in the cases with myocardosis (Wuhrmann) or Hegglin's syndrome, and the extent of the overlapping of these two disorders was discussed.
- 千葉大学の論文
- 1958-05-28
著者
関連論文
- 心エコー図で診断しえた左房粘液腫の1手術例
- 心臓の伝導異常を伴ったNoonan症候群の一例
- 4)健康診断用カラー画像処理システム([テレビジョン方式・回路研究会(第108回) 画像処理・画像応用研究会(第82回)]合同)
- アルコール心筋病
- 健常,および,病態における心・脈管力学,とくに, Blumberger-Holldack法,ならびにWezler法による研究について