| Japanese |
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| Title | 心電図と経食道エコーによる心筋虚血の診断 |
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| Subtitle | 特集 シンポジウム =International Symposium on Ischemic Heart and Anesthesia= |
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| Authors | 野村実, 内田桂子, 芦刈英理, 吉田啓子, 岩出宗代, 近藤泉, 藤田昌雄, 鈴木英弘 |
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| Organization | 東京女子医科大学麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 13 |
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| Number | 3 |
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| Page | 427-431 |
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| Year/Month | 1992/ |
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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 | 左心機能良好な冠動脈再建術患者を対象に, 人工心肺前の心筋虚血の発生頻度を, 食道エコー(TEE)の壁運動異常(RWMA)で診断し, 心電図のST変化と比較検討した. 対象患者を, 冠動脈の覆患病変枝別に, 1枝病変群, 2枝病変群, 3枝病変群に分けた. 3枝病変群の, RWMAは45％と, 1枝病変群9％, 2枝病変群11％と比較して, 高い発生頻度であった. また, 心電図による心筋虚血の発生頻度は, 1枝病変群50％, 2枝病変群20％, 3枝病変群30％と低い検出率であり, 特に, 3枝病変群においては, 心電図のST変化は, 感度, 特異度とも低く, 心電図による心筋虚血の診断の限界が示唆された. 我々の, 以前の報告と総合すると, 重度の冠動脈病変を合併する患者においては, 心電図や血圧, 心拍数, Rate Pressure Product等のパラメーターは心筋虚血の指標とはならず, TEEによる壁運動異常の観察が重要である. しかし, TEEにもreal timeの解析等の問題があり, 今後の技術的, 臨床的使用法の検討が必要である. (Circ Cont 13(3)：427〜431, 1992) |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Detection of Myocardial Ischemia by Electrocardiography and Transesophageal Echocardiography |
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| Subtitle | |
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| Authors | Minoru Nomura, Keiko Utida, Eri Ashikari, Keiko Yoshida, Motoyo Iwade, Izumi Kondo, Masao Fujita, Hidehiro Suzuki |
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| Organization | Department of Anesthesiology,Tokyo Women's Medical College |
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| Journal | Circulation Control |
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| Volume | 13 |
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| Number | 3 |
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| Page | 427-431 |
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| Year/Month | 1992/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | 「Introduction」Recent studies1)2)3) have suggested that intraoperative transesophageal echocardiography (TEE) provides useful information of hemodynamics during both cardiac and non-cardiac surgery. Despite apparent importance of perioperative ischemia, diagnosis of myocardial ischemia during anesthesia is not easy. Electrocardiography is one of the most popular monitoring and usually II and V5 lead are monitored during anesthesia. Rate pressure product (RPP) and triple index (TI) might suggest myocardial ischemia due to increase of myocardial oxygen consumption. But recent studies reveal RPP and TI are not a good indicator of myocardial ischemia. V wave by PCWP pressure trace is also not enough to detect myocardial ischemia. 「Method」We studied fifteen patients scheduled for elective coronary bypass graft surgery before cardiopulmonary bypass. Left ventricular ejection fraction of the patients were more than 50%. Fifteen patients were divided into three groups: single vessel disease (n=5), double vessel disease (n=5), triple vessel disease (n=5). |
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| Practice | Basic medicine |
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