物理的循環分析法の吟味と改良

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1. In accordance with Blumberger-Holldack's and Wezler's methods controlled by Fick-Cournand's method, the hemodynamical values of both left ventricle and greater circulation were measured in 150 normal subjects, 294 patients with essential hypertension, 47 with essential hypotension on the one hand, and those of both right ventricle and lesser circulation were determined in 19 normal subjects, 22 cases of bronchial asthma with or without emphysema and 14 of mitral stenosis on the other hand. The variation index of the left ventricular dynamical values was found about 10% and that of the greater circulatory dynamical values about 30%. The variation index of the elasticity coefficient in the lesser circulation was considerably large. On the whole the variation index of the cardio-vascular dynamical values tended to be found greater in pathological states than in normal health. 2. The fluctuation of the dynamical values in both left ventricle and greater circulation during 5 as well as 10 minutes' observation was examined in 40 normal subjects and 41 patients with essential hypertension of W + E' (resistance and elasticity) type. The range of the fluctuation of each cardio-dynamical value was not always equal, but most of the kinds of the values showed either in- or decrease in the fluctuation within 10%, except that DAZ (pressure elevation period of the left ventricle) attained a maximum fluctuation of 30%. 3. On the assumption that the fluctuation during 3 minutes is "measurement error" and the fluctuation during 30 minutes is "spontaneous or natural", the natural fluctuation of the dynamical values of both left ventricle and greater circulation was calculated in every group of 10 subjects with normal health, essential hypertension or essential hypotension respectively. In the normal group heart rates, ASZ (tension period of the left ventricle), ATZ (ejection period of the left ventricle), QH tone interval and QT duration showed the natural fluctuation beyond the extent of the measurement errors. 4. About 80 cardiac cycles of each group of 2 subjects with normal health or essential hypertension respectively, the respiratory fluctuation of the hemodynamical values in the greater circulation was observed. The systolic pressure showed the tendency to increase during expirium and the heart rates to increase during inspirium. The respiratory fluctuation of the other hemodynamical values was also significantly found, however its direction to in- or decrease was variable according to the sorts of the dynamical values. 5. The respiratory fluctuation of the dynamical values of the right ventricle was investigated on 36 cardiac cycles of one normal subjects, 40 cardiac cycles of one patient with bronchial asthma, 40 cardiac cycles of one patient with pulmonary emphysema and 14 cardiac cycles of one patient with mitral stenosis. Among normal subjects and patient with bronchial asthma the expiratory increase could be seen in UFZ' (transformation period of the right ventricle) and pulmonary systolic as well as diastolic pressure ; ATZ' (ejection period of the right ventricle) of the normal subject and DAZ' (pressure elevation period of the right ventricle) and ASZ' (tension period of the right ventricle) of the patient with bronchial asthma were also significantly prolonged during expirium. While pulmonary systolic pressure, ATZ' and ratio of ATZ' to ASZ' increased during inspirium, UFZ', DAZ' and ASZ' increased during expirium in the patient with pulmonary emphysema. 6. The cardio-dynamical values of the left ventricle obtained by Blumberger-Holldack's, Reindell-Klepzig's and v. Dungern's methods were compared about 100 cardiac cycles in each of 50 subjects with normal health or essential hypertension respectively. Vz (delayed time) calculated by Reindell-Klepzig's method was found longer than that by Blumberger-Holldack's. ASZ obtained by Reindell-Klepzig's method was nearly the same as that by Blumberger-Holldack's, however occasionally a certain difference of ASZ could be seen between the former two methods and v. Dungern's. ATZ gained by v. Dungern's method tended sometimes to be prolonged. For the judgement of the mode of the cardio-dynamics, almost the same results could be gained both by Reindell-Klepzig's and Blumberger-Holldack's methods, whereas v. Dungern's method showed somewhat different results from those obtained by the former two methods. 7. In each of 8 subjects with normal health or essential hypertension respectively, the site of the aortic ostium was determined by means of retrograde catheterization and angiography ; thus there was measured the central arterial pulse-wave velocity between aorta and carotid artery at which the pulse-waves were registered. The central pulse-wave velocity was found larger than the mean velocity of the pulse-wave in the aortic "windkessel" system. The difference between the former and the latter tended to be shown greater in the middle or the older aged than in the juvenile and moreover this difference larger in the hypertensive than in the normotensive.
千葉大学の論文
1963-03-28

物理的循環分析法の吟味と改良

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