Time variation of mitral regurgitant flow in patients with dilated cardiomyopathy.
Time variation of mitral regurgitant flow in patients with dilated cardiomyopathy.
复制标题
扩张型心肌病患者二尖瓣反流的时间变化。
DOI：
10.1161/01.cir.74.4.684
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发表时间：
1986
期刊：
影响因子：
37.8
通讯作者：
Yellin,EL
中科院分区：
文献类型：
--
作者：
Keren,G;LeJemtel,TH;Zelcer,AA;Meisner,JS;Bier,A;Yellin,EL
二尖瓣反流患者的血管造影结果显示，高达50%的返流量发生在射血前期。这与麻醉犬二尖瓣返流的电磁测量结果形成了鲜明的对比，后者表明只有5%的二尖瓣返流发生在射血前。因此，我们使用二维和多普勒超声心动图对8例严重心力衰竭患者在主动脉射血期间以及射血前和射血后的二尖瓣返流进行了量化。二尖瓣返流体积(RV)计算为总每搏输出量(二维超声心动图)与主动脉前向血流(脉冲多普勒)之差。用连续波多普勒仪测量返流速度(V)和时间(RT)，根据RT和平均返流速度(Vm)计算平均返流面积(Ram)：Ram=(RV/Rt)/Vm。作为第一个近似值，假定动脉在收缩期间是恒定的，在主动脉射血期间以及射血前和射血后的返流体积由如下公式计算：Rvi=(VMI)(Rti)()，其中Ti代表适当时间段的持续时间。射血前、射血、射血后返流量占总返流量的百分比分别为13+/-4%、79+/-5%、8+/-5%。因此，与先前报道的血管造影术研究不同，二尖瓣返流主要发生在主动脉射血期。假设射血前和射血期之间的有效返流口面积减少20%，这些结果并没有实质性改变，这与长期接受二尖瓣返流的犬的数据是一致的。
Angiographic results in patients with mitral regurgitation suggest that up to 50% of the regurgitant volume occurs during the preejection period. This contrasts markedly with the electromagnetic measurements of mitral regurgitant flow in anesthetized dogs, which suggest that only 5% of mitral regurgitant flow occurs during the preejection period. Therefore, we used two-dimensional and Doppler echocardiography to quantify mitral regurgitation during aortic ejection and in the preejection and postejection periods in eight patients with severe heart failure. Mitral regurgitant volume (RV) was calculated as the difference between total stroke volume (by two-dimensional echocardiography) and forward aortic flow (by pulsed Doppler). Regurgitant velocity (V) and time (RT) were measured by continuous-wave Doppler, and the mean regurgitant area (RAm) was calculated from the RT and mean regurgitant velocity (Vm): RAm = (RV/RT)/Vm. As a first approximation, the RA was assumed to be constant during systole, and the regurgitant volume during aortic ejection and during the preejection and postejection periods was calculated from: RVi = (Vmi) (RTi) (TAm), where Ti represents the duration of the appropriate period. Percentages of total regurgitant volume occurring during the preejection, ejection, and postejection periods were 13 +/- 4%, 79 +/- 5%, and 8 +/- 5%, respectively. Thus, in contrast to previously reported angiographic studies, mitral regurgitation occurs predominantly during the aortic ejection period. These results were not substantially changed by assuming a 20% reduction in effective regurgitant orifice area between the preejection and ejection periods and are consistent with data from chronically instrumented dogs with mitral regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)