| Japanese |
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| Title | 経食道ドプラ心エコー図法による僧帽弁逆流血流の評価 -麻酔科領域(I)- |
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| Subtitle | 特集 |
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| Authors | 赤松繁* |
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| Organization | *岐阜大学医学部麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 11 |
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| Number | 1 |
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| Page | 25-30 |
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| Year/Month | 1990/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 超音波ドプラ法の実用化により心腔内血流を非観血的に実時間で捉えることが可能となり, 心エコー図法は著しく発展した. ドプラ心エコー図法は, 先天性心疾患や弁膜症などの診断や評価に広く用いられている. 中でも弁逆流の検出において本法は優れた方法であり1), 健常者にも弁逆流血流が存在することが明らかとなってきた2)-6). また, 従来の経胸壁ドプラ心エコー図法による非侵襲的な弁逆流の半定量的評価法も報告されている7)8). 経食道心エコー図法は超音波の心臓への新しいアプローチとして注目され9)10)近年急速に普及しつつあり, また術中モニターとしても用いられている11)-14). 経食道ドプラ心エコー図法は左房に接した食道内に探触子があるため, 僧帽弁逆流血流の検出に極めて優れている. しかし経食道ドプラ心エコー図法による僧帽弁逆流の半定量的評価は十分になされていない. 僧帽弁逆流血流は循環動態の変動に伴い逆流の程度が変化するため, 術中モニターとして用いる上においても経食道ドプラ心エコー図法による半定量的評価を確立しなければならない. また, 経食道ドプラ心エコー図法は僧帽弁逆流血流に対する感度が鋭敏すぎ, ほとんどの健常者において僧帽弁逆流血流が検出される6). |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Transesophageal Doppler echocardiographic assessment of mitral regurgitation |
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| Authors | Shigeru Akamatsu |
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| Organization | Department of Anesthesiology Gifu University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 11 |
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| Number | 1 |
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| Page | 25-30 |
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| Year/Month | 1990/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | To assess the usefulness of transesophageal Doppler echocardiography in estimating mitral regurgitation, 54 surgical patients were studied under general anesthesia. Both transesophageal Doppler echocardiography and left ventriculography were performed in 34 patients with mitral valve disorders or ischemic heart diseases. In addition to these patients, 20 other surgical patients without cardiac disorders were studied by transesophageal Doppler echocardiography. Mitral regurgitation was graded according to the classification of Sellers et al.：Group 0 (no regurgitation), Group I (mild), Group II (moderate), Group III (moderate to severe and severe), and Group N (no cardiac disorder). The maximum area of regurgitant jet signals was compared with the severity determined by left ventriculography. The area of regurgitant jet signals in group 1 was significantly larger than that in group 0 and N, and significantly smaller than that in group 2. There was no significant difference between the area of regurgitant signals in group 2 and that in group 3. Thus, estimation of the severity of mitral regurgitation by transesophageal color flow mapping seemed to be useful to a certain degree. In 70% of group N and 60% of group 0, the velocity of regurgitant flow measured by transesophageal pulsed Doppler echocardiography was less than 1 m/sec. In 30% of group N and 40% of group 0 and in all of other groups 1, 2 and 3, the velocity was more than 1 m/sec. The regurgitant flow with the velocity less than 1 m/sec, seems to be physiological regurgitation. In conclusion, transesophageal Doppler echocardiography is useful for semiquantitative evaluation of most degrees of mitral regurgitation except for severe regurgitation. |
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| Practice | Basic medicine |
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