NON-INVASIVE ASSESSMENT OF AORTIC REGURGITATION BY IMPEDANCE CARDIOGRAPHY

概要

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In 16 patients with aortic regurgitation without manifest congestive heart failure, impedance cardiogram by Kubicek's method was recorded at resting supine position. Splitting in the first derivative of the ejection wave (e wave) was found in 10 patients. In 2 patients who received aortic valve replacement, splitting in the e wave disappeared after the operation. Cardio-thoracic ratio (CTR) estimated from the chest X-ray picture, end-systolic and end-diastolic left ventricular dimensions by echocardiography and angiographic regurgitant index, were significantly increased in the patients with splitted waveform as compared with the non-splitted. Seven of 10 patients with the splitting had end systolic left ventricular dimension (LVDs) of 50 mm or greater. All patients with non-splitting had LVDs of 50 mm or less. To elucidate the haemodynamica bases of the splitting phenomenon in the e wave, RI angiocardiography was performed. The increased amplitude and delayed peak of the aortic volume curves were found in the cases with severe aortic regurgitation. This finding indicates that the splitted e wave is derived from the large amount of regurgitant flow toward the aorta. It may be concluded that formation of the splitting in the ejection wave in tha first derivative of impedance cardiogram is an indication for non-invasive assessment of the severity of the aortic regurgitation.
名古屋市立大学の論文
1984-10-29