Japanese
Title巨大左房縫縮術における心房心室間至適容量に関する実験的検討
Subtitle原著
Authors小見山秀一
Authors(kana)
Organization東京女子医科大学附属日本心臓血圧研究所循環器外科
Journal循環制御
Volume21
Number3
Page290-296
Year/Month2000/
Article原著
Publisher日本循環制御医学会
Abstract僧帽弁狭窄や逆流に合併する巨大左房の左房縫縮術に関しては左心房容量が左心室の拡張期に与える影響が不明な点が多く, 現在のところ的確に判定する指標はない. 今回は左房縫縮術の有効性を評価するため心房心室シュミレータを開発し, 至適な心房心室間容量を検討した. 左心房の急速流入期ピーク値, 左心房コンプライアンスを指標とした結果, 急速流入期ピーク値の最大値は左心房容量100ml, 左心房コンプライアンス0.81ml/mmHgのときに67cm/secとなり, また生体に近似した波形を記録した. 左心房容量の増加に伴って左心室拡張期末の絶対容量が増大する正の相関が認められ左心房容量の減少に伴って前負荷が減少している可能性が示唆された. したがって急速流入期における左心室への血液の流入を促進させるという点で左房縫縮術の意義が示された.
Practice基礎医学・関連科学
KeywordsLeft atrial plication, Giant left atrium, Atrio-ventriclular mechanical simulator, Rapid inflow period peak, LA compliance
English
TitleExperimental Examination Regarding the Optimum Volume between the Atrium and the Ventricle in Giant left Atriun Plication.
Subtitle
AuthorsShuichi Komiyama
Authors(kana)
OrganizationDepartment of Cardiovascular Surgery,The Heart Institute of Japan,Tokyo Women's Medical University
JournalCirculation Control
Volume21
Number3
Page290-296
Year/Month2000/
ArticleOriginal article
PublisherJapan Society of Circulation Control
Abstract「Background:」 Today the influence that left atrium volume gives to the left ventricle (LV) in end-diastolic period regarding the left atrial (LA) plication of giant left atrium that merge to mitral valve stenosis or mitral valve regurgetation is still contraversial. Atrioventriclular mechanical simulator was developed to evaluate the efficacy of LA plication and was examined on the optimum volume between atrium and ventricle. Rapid inflow period peak which was made passively during inflow period from LA to left ventricle (LV) was relayed to the energy saved in LA during LV contraction period. For those reasons, the rapid inflow period peak was determined to be the evaluation item. Also LV end-diastolic volume (LVEDV) recognized as LV preload and the influence that LA compliance gives to LVEDV was measured to make clear the significance of the LA plication. 「Methods:」 Being the rapid inflow period peak and LA compliance as the evaluation item, the mitral valve flow wave form that approximated the living body was obtained. The correlation between LA and LV volume and the inflow of the fluid to the left ventricle in the rapid inflow period were measured. 「Results:」 Mitral valve wave form of mechanical simulator was much like that of living body. The maximum rapid inflow period peak value was 67cm/sec at the time of 0.81ml/mmHg of LA compliance along with 100ml of LA volume. There was a positive correlation between LA volume and LVEDV (P=0.00015, r2;0.6802). LVEDV was decreased along with the decrease of LA volume at the time of 0.81ml/mmHg of LA compliance. 「Conclusion:」 It was prooved that LA plication in giant LA promoted the inflow of the fluid to the left ventricle in the rapid inflow period using our mechanical atrio-ventricular simulator.
PracticeBasic medicine
KeywordsLeft atrial plication, Giant left atrium, Atrio-ventriclular mechanical simulator, Rapid inflow period peak, LA compliance

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