在前壁心肌梗塞病患以左心室內等體積舒張期血流形式來改良杜卜勒超音波心圖預測左心室填充壓的能力
Date Issued
2002
Date
2002
Author(s)
吳造中
DOI
902314B002340
Abstract
Background and purpose: Previous studies have shown that left ventricular systolic
asynchrony affects both the relaxation and filling phases of diastole. The purpose of
this study was to delineate how the anterior wall dyssynergy influenced the
intraventricular flow redistribution patterns during isovolumic relaxation period.
Methods: Seventy-three patients with anterior wall myocardial infarction and
dyssynergy were enrolled. Those who exhibited the whole isovolumic relaxation
intraventricular flow redistributing toward the mitral apparatus, which indicated the
reverse physiologic intraventricular pressure gradient in early diastole, were classified
as group B, otherwise, as group A. The Doppler echocardiographic variables of mitral
inflow were correlated with the left ventricular end-diastolic pressures (LVEDP).
Results: With lower ejection fraction rate and more apical dyssynergy, the group B
patients had much slower mitral flow propagation. For group A patients, the
independent determinants for LVEDP were the ratio of mitral flow propagation rate to
peak velocity in early diastole, the early mitral flow deceleration time and the
isovolumic relaxation time, all occurring in early diastole. In contrast, the only independent determinant for LVEDP in group B patients was the ratio of mitral peak
flow velocity in early diastole to that in late diastole.
Conclusions: The intraventricular isovolumic relaxation flow patterns could delineate
how the left ventricular systolic dyssynergy influenced the diastolic process, and
determine which echocardiographic variables were more useful for predicting LVEDP
in patients with anterior wall myocardial infarction.
Subjects
myocardial infarction
isovolumetric relaxation flow pattern
left
ventricular filling pressure
ventricular filling pressure
Publisher
臺北市：國立臺灣大學醫學院內科
Type
report
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