Pressure Gradients without Obstruction: A New Concept of “Hypertrophic Subaortic Stenosis”
Pressure Gradients without Obstruction: A New Concept of “Hypertrophic Subaortic Stenosis”
复制标题
无阻塞压力梯度：“肥厚性主动脉瓣下狭窄”的新概念
DOI：
10.1161/01.cir.32.6.881
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发表时间：
1965
期刊：
影响因子：
37.8
通讯作者：
R. Ross
中科院分区：
文献类型：
--
作者：
B. J. M. Criley;K. B. Lewis;R. White;R. Ross
摘要与结论在7例“肥厚性主动脉瓣下狭窄”患者中，左心室电影心血管造影未发现明显的流出道梗阻。经左心室的导管回撤，经电影透视记录，将高压区定位于收缩早期完全排空的左心室部分。左心室空部持续收缩为心脏压力梯度提供了一个解释。异丙肾上腺素输注可增加左室排空的速度和程度，使腔部分提前，压力梯度增加。梯度产生无梗阻的机制与输注异丙肾上腺素的犬相似。这些患者的心肌异常增厚，左室排空快于正常，因此出现了一种“肥厚型肥大动力型心肌病”。
Summary and Conclusions Significant outflow tract obstruction was notseen byleft ventricular cineangiocardiography in seven patients with "hypertrophic subaorticstenosis."Catheter withdrawals through the leftventricle, recorded cinefluorographically, lo-calized the high pressure areas to portions ofthe left ventricle which emptied completely in early systole. Sustained systolic contractionin empty portions of the left ventricle pro-vides an explanation for the pressure gradi-entsinthesepatients.Isoproterenol infusions increased the rate and degree of left ventricular emptying, ob-literating portions of the cavity earlier andincreasingthepressure gradient.Themechanismof gradient production with- out obstruction was similar to the phenome-non observed in dogs receiving isoproterenol infusions. The cardiac muscle in these patients is ab-normally thick and the left ventricle emptiesmorerapidly than normal; therefore a "hyper- trophic hyperkinetic cardiomyopathy" is present.The nonobstructive