肺循環にかんする研究,とくに肺高血圧について

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Fick-Cournand's, Wezler's and Blumberger-Holldack's methods were simultaneously performed in the cases suffered from congenital heart disorders, valvular cardiac diseases and bronchial asthma with or without emphysema thoracis. These results were comparatively investigated, especially the relationship between pulmonary flow, pulmonary arterial pressure, pulmonary wedge pressure, total pulmonary resistance and pulmonary arteriolar resistance was studied. Furthermore the relationship between these hemodynamical factors and ecg, x-ray kymogram with respect to the right ventricular hypertrophy and dilatation was observed. 1. The increase in the pulmonary flow reduces the pulmonary arteriolar resistance, the augmentation of the pulmonary arteriolar resistance tends to diminish the pulmonary flow. However in the cases with patent ductus arteriosus or lower ventricular septum defect there are found the increased pulmonary flow and the augmented pulmonary arteriolar resistance. 2. As to the relationship between the pulmonary and the total pulmonary vascular resistance in the aquired heart diseases, the similar tendency to that obtained in §1 is also observed in the congenital heart disorders, but in the latter there are often exceptions to this rule owing to the causes above mentioned. 3. In bronchial asthma the increase in the pulmonary arteriolar resistance is more striking than that in the total pulmonary vascular resistance, whereas in mitral valvular diseases the augmentation of the pulmonary arteriolar resistance is not, so marked as that of the total pulmonary vascular resistance, and in congenital heart disorders it seems not to find the definit tendency. 4. In the cases with right ventricular hypertension, the increase in Mr, Tr, Br, L and Fl of x-ray kymogram is frequently observed, whereas in the cases with augmentation of pulmonary wedge pressure, total pulmonary vascular resistance and pulmonary arteriolar resistance, the increase in L_2 is often seen. In the former it appears to exist the prolongation of the right ventricular inflow path (filling-dilatation), in the latter that of the outflow path (resistance-dilatation). 5. In those who show the increase of Mr, there can be electrocardiographically more often found right position type, clock-wise rotation, prolonged QRS duration, and delayed intrinsicoid deflection of Vt. Regarding cardiac surface area and electrocardiographic finding, there can be more frequently observed wide QRS, prolonged QT and delayed intrinsicoid deflection of V_1 in the cases with increased cardiac surface area. 6. Denecke syndrome is more often seen in the cases with increased Mr, Tr, Br, L and Fl. 7. As to the relationship between the clock-wise rotation of heart axis in ecg. and Denecke syndrome, the patients without clockwise rotation show more frequently this syndrome. 8. Besides, it can be said that Denecke syndrome is almost always only found in the cases With delayed intrinsicoid deflection of V_1 or V_6, i.e. in the patients without any delayed intrinsicoid deflection of V_1 or V_6 there can hardly be observed. 9. The influence of various cardio-vascular drugs upon cardiac output was studied by means of Fick-Cournand's and simultaneously performed Wezler's methods. The results obtained by two methods were well agreeable in 13 of 1.5 cases. 10. The cardiac output before and after Fick-Cournand's method was determined by Wezler's and Broemser-Ranke's method. Wezler's value obtained before and after Fick-Cournand's method was found more agreeable with Fick-Cournand's value than Broemser-Ranke's value. Wezler's and Broemser-Ranke's values estimated after Fick-Cournand's method were found higher than those before Fick-Cournand's method although there could not be observed any significant difference between two sorts of values.

肺循環にかんする研究,とくに肺高血圧について

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