| Japanese |
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| Title | 4. Right Ventricle Unloading Therapy |
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| Subtitle | 特集-第6回循環制御研究会記録 IV. シンポジウム「心拍出量とAfterloadを考える」 |
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| Authors | 公文啓二*, 平田隆彦*, 田中一彦*, 山本文雄**, 内藤泰顕**, 藤田毅** |
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| Authors(kana) | |
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| Organization | *国立循環器病センターICU, **国立循環器病センター心臓外科 |
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| Journal | 循環制御 |
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| Volume | 6 |
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| Number | 3 |
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| Page | 311-317 |
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| Year/Month | 1985/ |
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| Article | 報告 |
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| Publisher | 日本循環制御研究会 |
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| Abstract | 「要約」低心拍出量症候群(LOS)が肺高血圧症や右心不全に起因する場合には, その治療手段として左室前負荷を規定する右室のafterloadをとる方法(Right ventricle unloading therapy)を要する場合がある. その病態を示すとともに, 肺高血圧症の2症例を呈示しinotropic agentとして交感神経系α受容体刺激剤は肺高血圧症を増悪するため禁忌でありβ受容体刺激剤が有用であることおよびCa++拮抗剤であるニカルジピンがspasticな肺動脈に対して反応性の肺血管収縮を抑制する可能性を示した. さらに, Thermo-dilution法による心拍出量および右室駆出率(RVEF)を測定して代表的な肺血管拡張薬の右室-肺循環系に及ぼす影響について検討した結果, トラゾリンは著明に肺血管抵抗を下げ心拍出量を増加させるが, RVEFは不変, ニカルジピンは肺血管抵抗, 心拍出量, RVEFのいづれもの低下作用, イソプロテレノールおよびドブタミンは肺血管抵抗を下げ, RVEFを増し心拍出量を著明に増加する作用のあることが確認された. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Right ventricle unloading therapy |
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| Subtitle | |
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| Authors | Keiji Kumon, Takahiko Hirata, Kazuhiko Tanaka, Fumio Yamamoto, Yasuaki Naito, Tsuyoshi Fujita |
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| Authors(kana) | |
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| Organization | ICU and cardiovascular surgery, National cardiovascular Center |
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| Journal | Circulation Control |
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| Volume | 6 |
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| Number | 3 |
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| Page | 311-317 |
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| Year/Month | 1985/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | The after-load of right ventricle (RV) regulated the pre-load of left ventricle in a patients with pulmonary hypertension (PH) and/or right ventricular failure (RVF). In these circumstances, therefore, RV unloading therapy is essential for the management of low cardiac output syndrome (LOS) caused by PH and/or RVF. We have studied RV unloading therapy on the patients who possessed different pathophysiological background and the results were demonstrated in this paper. Pulmonary arterial-systemic pressure ratio (Pp/Ps) of a patient suffering from pulmonary embolism was very high of closely 1.35 under the administration of epinephrine (Ep) and it was markedly decreased to 0.7 when the isoproterenol was administered instead of Ep. In a patient who received mitral valve replacement, pulmonary vasospastic hypertension which developed in association with the weaning from mechanical ventilation was successfully controlled by the administration of nicardipine. Effects of some pulmonary dilating agents on RV-pulmonary circulation system were also studied. |
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| Practice | Basic medicine |
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| Keywords | |
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