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Blood Flow Dynamics of Left Coronary Artery in Hypertrophied Human Heart

肥大的人心脏左冠状动脉的血流动力学

基本信息

批准号：
01570796
负责人：
FUJIWARA Takashi
金额：
$ 1.41万
依托单位：
Kawasaki Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1990
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-01570796/
关键词：
coronary artery flow velocity wave form left ventricular hypertrophy pulsed Doppler velocimeter atrial pacing 左冠動脈血流波形大動脈弁狭窄症人工弁置換術

项目摘要

To clarify the characteristics of the left coronary blood flow velocity wave forms in left ventricular hypertrophy, we analyzed phasic flow velocity wave forms of left anterior descending coronary artery (LAD) in the patients with aortic regurgitation and stenosis before and after aortic valve replacement using an 80-channel 20 MHz pulsed Doppler velocimeter, and the influence of increase in heart rate on the velocity wave forms was studied by atrial pacing during cardiac operations.In aortic regurgitation, the LAD flow was characterized by an increase in the systolic flow component, a small and rapidly decreased diastolic flow. An increase in heart rate by pacing brought about a decrease in systolic flow and an increase in diastolic flow component. After aortic valve replacement, systolic flow decreased by 36.3 + 21.7%, whereas diastolic flow markedly increased by 81.4 + 51.8%. These findings suggest that the increase in heart rate in aortic regurgitation and aortic valve replacement … More induce beneficial effects on the myocardial inflow.The LAD flow velocity wave form in aortic stenosis was characterized by a reverse flow in systole and a slowly increasing diastolic inflow. The time from onset of diastole to the diastolic peak velocity (T-DPV) lengthened in all patients and did not change after an increase in heart rate by pacing. The apparent changes in diastolic flow pattern were observed at the pacing rate of 120, that was, the peak region of diastolic flow velocity overlapped with QRS of subsequent systole, therefore, increasing diastolic inflow rapidly decreased. These findings suggest that the increase in heart rate brings about markedly decrease in coronary blood flow in aortic stenosis. After aortic valve replacement, the increasing rate of the diastolic inflow was augmented and T-DPV was shortened from 176.8 + 28.8 to 90.5 + 18.8 cm/s. In addition, the diastolic peak velocity increased from 90.5 + 28.0 to 122.5 + 17.2 cm/s. These changes suggest the beneficial effects of removal of aortic stenosis on human coronary artery inflow. Less

为明确左室肥厚患者左冠状动脉血流速度波形的特点，应用80导联20 MHz脉冲多普勒测速仪分析了主动脉瓣关闭不全和狭窄患者主动脉瓣置换术前后左冠状动脉前降支(LAD)的时相血流速度波形，并在心脏手术中进行心房起搏，研究心率增加对LAD血流波形的影响。起搏增加心率会导致收缩血流减少，舒张期血流成分增加。主动脉瓣置换术后，收缩期血流减少36.3±21.7%，舒张期血流显著增加81.4±51.8%。这些发现提示，主动脉瓣反流和主动脉瓣置换术中的心率增加…主动脉瓣狭窄患者左前降支血流速度波形表现为收缩期内反向血流，舒张期内流量缓慢增加。所有患者从开始舒张期到舒张期峰值速度(T-DPV)的时间延长，起搏后心率增加后无变化。当起搏频率为120时，可观察到舒张期血流模式的明显变化，即舒张期血流速度的峰值与随后收缩的QRS重叠，因此，增加的舒张期流入迅速减少。这些结果表明，心率的增加导致主动脉狭窄患者的冠脉血流量明显减少。主动脉瓣置换术后，舒张期血流速度增加，T-DPV由176.8士28.8缩短至90.5士18.8 cm/S，舒张期峰值速度由90.5士2 8.0增至122.5士17.2 cm/S。较少