The First Heart Sound in Atrial Septal Defect with Reference to Atrioventricular Valve Motion and Hemodynamics.
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概要
- 論文の詳細を見る
To clarify the characteristics of the first heart sound in atrial septal defect (ASD) and its pathophysiological basis, 17 patients with ASD associated with incomplete right bundle branch block (IRBBB) and 7 with isolated IRBBB were studied using phonoechocardiography and Doppler echocardiography. Fifteen of the 17 ASD patients also were studied following surgical closure of the defect. Indices were compared among the preoperative ASD, postoperative ASD, and IRBBB groups including: P-Q intervals, loudness of the mitral and tricuspid component of the first heart sound (IM, IT), enddiastolic closing excursions of the mitral and tricuspid valves (MX, TX), and mitral and tricuspid inflow velocities during early diastole and atrial contraction. There were no significant differences in the P-Q intervals among these 3 groups. IM was attenuated, and IT was accentuated in ASD compared with IRBBB. Postoperatively, IM was augmented in all but l patient and IT was attenuated in all patients. MX was significantly smaller, and TX was significantly larger in ASD than in IRBBB. Postoperatively, MX was significantly increased and TX was significantly reduced; the maximal mitral inflow velocity during atrial contraction was increased while the maximal tricuspid inflow velocity was significantly reduced. Thus, the first heart sound in ASD is characterized by an attenuated mitral component and an accentuated tricuspid component. Hemodynamic alterations and consequent changes in closing energies of the atrioventricular valves probably account for these features.
- International Heart Journal刊行会の論文
著者
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Yamada Hirotsugu
The University of Tokushima Graduate School of Medicine
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ITO SUSUMU
Second Department of Internal Medicine, School of Medicine, University of Tokushima
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Tabata Tomotsugu
Second Department of Internal Medicine
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Yamada Hirotsugu
Second Department of Internal Medicine
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IUCHI Arata
Second Department of Internal Medicine,University of Tokushima
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MANABE Kazuyo
Second Department of Internal Medicine,University of Tokushima
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Sasaki Miwa
Second Department of Internal Medicine, School of Medicine, University of Tokushima
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Oki Takashi
Second Department Of Internal Medicine
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Ito Susumu
Second Department Of Internal Medicine School Of Medicine University Of Tokushima
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FUKUDA Nobuo
Institute for Clinical Research, Zentsuji National Hospital
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TABATA Tomotsugu
Second Department of Internal Medicine, School of Medicine, University of Tokushima
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YAMADA Hirotsugu
Second Department of Internal Medicine, School of Medicine, University of Tokushima
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MANABE Kazuyo
Second Department of Internal Medicine, School of Medicine, The University of Tokushima
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IUCHI Arata
Second Department of Internal Medicine, Faculty of Medicine, Tokushima University
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IUCHI Arata
Second Department of Internal Medicine, School of Medicine, University of Tokushima
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