LEFT VENTRICULAR ENLARGEMENT AND HYPERTROPHY - A CLINICAL AND ANGIOCARDIOGRAPHIC STUDY
LEFT VENTRICULAR ENLARGEMENT AND HYPERTROPHY - A CLINICAL AND ANGIOCARDIOGRAPHIC STUDY
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DOI：
10.1016/0002-9343(65)90111-7
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发表时间：
1965-01-01
影响因子：
5.9
通讯作者：
BUNNELL, IL
中科院分区：
文献类型：
--
作者：
GRANT, C;GREENE, DG;BUNNELL, IL
在一组 25 名患者中，将左心室对压力负荷（流出阻塞）和容量负荷（瓣膜反流疾病）的适应与左心室的正常功能及其在心肌疾病存在下的功能进行了比较。对压力负荷的适应是通过同心肥大（增加壁厚而不扩大腔室）。这些正常尺寸的腔室中的填充压力可能会升高。随着容量负荷的增加，心室扩大，壁厚也成比例增加；这些大心室的舒张末期压力可能是正常的，这表明它们没有因心室衰竭继发的充盈压升高而被拉伸。如果扩大归因于类似于婴儿心室转变为成人心室的生长过程，则可以解释扩大的心室中正常充盈压力的明显悖论。这种病理性生长被称为偏心肥大。这一概念得到了已发表的形态学研究的支持，表明组织的伸长是通过生长而不是拉伸而发生的。提出了偏心肥大的精确定义（增大而不改变形状或相对壁厚）。当适应性肥大导致左心室扩大时，认为这是心室衰竭的征兆可能是错误的。
In a group of 25 patients the adaptations of the left ventricle to a pressure load (outflow obstruction) and to a volume load (regurgitant valvualr disease) have been compared with the normal function of the left ventricle and its function in the presence of myocardial disease. Adaptation to a pressure load is by concentric hypertrophy (increase in wall thickness without chamber enlargement). Filling pressure may be raised in these normal-sized chambers. With a volume load there is enlargement of the ventricle and a proportionate increase in wall thickness; end-diastolic pressure may be normal in these large chambers, indicating that they have not been stretched by a rise in filling pressure secondary to ventricular failure. The apparent paradox of normal filling pressure in an enlarged chamber can be explained if the enlargement is attributed to a growth process similar to the conversion of an infant''s ventricle into that of an adult. This form of pathologic growth has been called eccentric hypertrophy; the concept is supported by published morphologic work indicating that elongation of tissues take place by growth rather than by stretching. A precise definition of eccentric hypertrophy is proposed (enlargement without change in shape or relative wall thickness). When an enlarged left ventricle is produced by adaptive hypertrophy, it si probably wrong to consider this a sign of ventricular failure.