| Japanese |
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| Title | 新しい循環指標としての左心-動脈カップリング(Ees/Ea)の臨床応用について |
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| Authors | 林和子*, 重見研司*, 田中義文* |
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| Organization | *京都府立医科大学麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 19 |
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| Number | 4 |
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| Page | 529-537 |
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| Year/Month | 1998/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」左心-動脈カップリング(Ees/Ea)とは, 左心室, 動脈それぞれの弾性腔としての特性を, 収縮期末左心弾性(Ees)と実効動脈エラスタンス(Ea)として定量化した場合の左心と動脈の結合のバランスであり, 機能的心拍出率や心拍出効率を表すとともに, 循環動態推移により一律の方向性を持って変化する循環調節における重要な因子である1〜4). 今回, 私たちは, 左心室時変エラスタンスと心収縮期時相解析によるEes/Eaの簡易な算定法を開発し, この方法を用いて, 褐色細胞腫腫瘍摘出術, 心臓外科手術の人工心肺離脱時, 脳外科手術症例において, Ees/Eaの推移を経時的に測定し, 興味ある知見を得たので報告する. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Clinical Monitoring of Ventricular Arterial Coupling as a New index for the Cardiovascular Condition Based on Left Ventricular Time-varying Elastance |
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| Authors | Kazuko Hayashi*, Kenji Shigemi*, Yoshifumi Tanaka* |
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| Organization | *Department of Anesthesiology, Kyoto Prefectural University of Medicine |
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| Journal | Circulation Control |
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| Volume | 19 |
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| Number | 4 |
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| Page | 529-537 |
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| Year/Month | 1998/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Ventricular arterial coupling (Ees/Ea), the ratio of the elastance between the left ventricle and aorta at the end-systolic phase, serves as a useful index to evaluate energetic and mechanical performance of the heart. In this research, we proposed a new concept to evaluate Ees/Ea, based on the stability of the left ventricular time-varying elastance. We previously found, timevarying elastance, E (t), was relatively independent of the loading conditions. When E (t) had a unique time course, theoretical analysis indicated that, for a given set of ventricular pressures and systolic time intervals, Ees/Ea could be estimated by the equation, Ees/Ea=Pad/Pes×(1+0.65×LVET/PEP)-1, where Pes is end-systolic pressure, Pad is aonic diastolic pressure, PEP is pre-ejection time, and ET is ejection time. We measured these parameters to estimate Ees/Ea by simultaneously monitored radial arterial pressure waves, electrocardiography, and esophageal phonocardiography in patients under general anesthesia during surgery. |
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| Practice | Basic medicine |
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| Keywords | Ventricular arterial coupling, Mechanical efficiency, Ejection fraction, Contractility, Afterload |
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