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[ECG-gated magnetic resonance imaging using a surface coil]. [使用表面线圈的脑电图门控磁共振成像]。
Pub Date : 1986-03-01
F Saeki, K Inoue, K Yamakawa

ECG-gated magnetic resonance imaging (MRI) was performed for healthy volunteers and for patients with various heart diseases, and its usefulness was compared with that of two-dimensional echocardiography. For this study, several modifications were made in the MRI equipment used. First, a surface coil was introduced for recording the MR signal, resulting in a high S/N ratio. Second, an oblique scan mode was developed for selecting freely the slices similar to those chosen by two-dimensional echocardiography. For imaging, the back projection method and spin echo (SE) pulse sequence were chosen to minimize motion artifacts caused by cardiac beats. In this study, left ventricular wall thickness and left ventricular volume were estimated from gated MR images, taken both in the horizontal and oblique longitudinal scan modes. The results were as follows: The anterior, inferior and apical left ventricular walls were clearly visualized with oblique longitudinal scan images. The thickness of the interventricular septum and posterior wall were measured on left ventricular horizontal scan images. Each measurement was compared with data obtained by two-dimensional echocardiography. Both correlation factors were about 0.70, indicating poor correlations. Left ventricular ejection fraction was calculated from left ventricular volume estimates. Comparison of left ventricular ejection fractions estimated by MRI and two-dimensional echocardiography revealed a close similarity. We concluded that MRI is useful for non-invasive evaluation of cardiac function, and in detecting wall thickness abnormalities due to various heart diseases.

对健康志愿者和患有各种心脏病的患者进行了心电图门控磁共振成像(MRI),并将其与二维超声心动图的有效性进行了比较。在这项研究中,对所使用的MRI设备进行了一些修改。首先,引入了一个表面线圈来记录MR信号,从而获得了高信噪比。其次,建立了一种类似于二维超声心动图的斜位扫描模式,可以自由选择切片。在成像方面,选择了反向投影法和自旋回波(SE)脉冲序列,以最大限度地减少心跳引起的运动伪影。在这项研究中,左心室壁厚度和左心室容积通过门控磁共振图像估计,在水平和倾斜纵向扫描模式下拍摄。结果表明:左室前壁、下壁和心尖部斜向纵向扫描图像清晰可见。在左室水平扫描图像上测量室间隔和后壁厚度。将每项测量结果与二维超声心动图所得数据进行比较。相关因子均约为0.70,相关性较差。左心室射血分数由左心室容积估计计算。通过MRI和二维超声心动图对左心室射血分数进行比较,发现两者非常相似。我们的结论是,MRI是有用的无创评估心脏功能,并在检测壁厚异常引起的各种心脏疾病。
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引用次数: 0
[Analysis of ventricular wall motion using multislice ECG-gated cardiac X-ray CT: application of the three-dimensional reconstruction technique]. [多层心电图门控心脏x线CT心室壁运动分析:三维重建技术的应用]。
Pub Date : 1986-03-01
K Urasawa, S Kakinoki, I Sakuma, K Kanamori, S Sakamoto, H Yasuda

A new computer system was proposed to evaluate abnormal motion of the ventricular wall in patients with myocardial infarction. Multi-slice ECG-gated cardiac X-ray CT (MSECT), a new technique developed in our laboratory, was the source of the original image. Using this system, we reconstructed three-dimensional images, calculated % shortening values of the entire heart, and visualized abnormal wall motion on the ventricular surface, displaying three-dimensionally. Our initial study of five patients with myocardial infarction showed good correlation between the findings using this system and conventional echocardiography and cine-ventriculography. Since the development of the ECG-gated method, the application of CT to the study of heart diseases has progressed rapidly. In patients with myocardial infarction, ECG-gated cardiac CT is used to visualize infarcted myocardium and to evaluate impaired cardiac function. However, such analyses were limited to single slices, because a large dose of contrast medium was required to distinguish the ventricular chamber from the myocardium. By adopting multi-slice ECG-gated cardiac X-ray CT images as the data source and using three-dimensional reconstruction technique, this system is useful for evaluating abnormal wall motion.

提出了一种新的计算机系统来评估心肌梗死患者心室壁的异常运动。多层心电图门控心脏x线CT (MSECT)是我们实验室开发的一种新技术,是原始图像的来源。利用该系统,我们重建了三维图像,计算了整个心脏的%缩短值,并在心室表面可视化了异常壁运动,三维显示。我们对5例心肌梗死患者的初步研究表明,使用该系统的结果与常规超声心动图和电影-心室造影的结果具有良好的相关性。自心电图门控方法发展以来,CT在心脏疾病研究中的应用进展迅速。在心肌梗死患者中,心电图门控心脏CT用于显示梗死心肌并评估心功能受损。然而,这种分析仅限于单片,因为需要大剂量的造影剂来区分心室和心肌。该系统以多层心电图门控心脏x线CT图像为数据源,采用三维重建技术,可用于异常壁运动的评估。
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引用次数: 0
[Relation of mitral valve motion to left ventricular end-diastolic pressure assessed by M-mode echocardiography]. [用m型超声心动图评价二尖瓣运动与左室舒张末期压的关系]。
Pub Date : 1986-03-01
N Ohte, S Nakano, Y Mizutani, T Samoto, T Fujinami

Left ventricular end-diastolic pressure (LVEDP) was estimated noninvasively using cardiac parameters obtained from simultaneous recordings of the echocardiograms, electrocardiograms and phonocardiograms in 30 patients who underwent diagnostic left cardiac catheterization. Special attention was paid to the mitral valve motion which reflects global left ventricular function. The interval from the onset of the Q wave of the ECG to the echocardiographic C point of mitral valve closure (Q-C), the interval from the aortic component of the second heart sound to the E point of the mitral echogram (IIa-E), and the time from the opening of the mitral valve (D point) to the E point (D-E) were measured. A good correlation with LVEDP was observed with Q-C/IIa-E (r = 0.87, p less than 0.001), and inversely with D-E time (r = -0.81, p less than 0.001). The correlation of Q-C/D-E and LVEDP was most significant (r = 0.89, p less than 0.001). The regression equations were LVEDP = 36.6 X (Q-C/IIa-E) -10.9 and LVEDP = 4.49 X (Q-C/D-E) +5.56. This noninvasive and easily repeated method for predicting LVEDP is very useful clinically.

对30例接受诊断性左心导管置入术的患者,采用超声心动图、心电图和心音图同时记录的心脏参数,无创地估计左室舒张末期压(LVEDP)。特别注意二尖瓣运动,反映整体左心室功能。测量心电图Q波起跳至二尖瓣超声C点的时间间隔(Q-C)、第二心音主动脉瓣瓣瓣瓣E点的时间间隔(IIa-E)、二尖瓣瓣开(D点)至E点的时间(D-E)。Q-C/IIa-E与LVEDP有良好的相关性(r = 0.87, p < 0.001),与D-E时间呈负相关(r = -0.81, p < 0.001)。Q-C/D-E与LVEDP相关性最显著(r = 0.89, p < 0.001)。回归方程为LVEDP = 36.6 X (Q-C/IIa-E) -10.9和LVEDP = 4.49 X (Q-C/D-E) +5.56。这种无创且易于重复的预测LVEDP的方法在临床上非常有用。
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引用次数: 0
[Severity and non-uniformity of regional wall motion in dilated cardiomyopathy evaluated by two-dimensional echocardiography]. [用二维超声心动图评价扩张型心肌病局部壁运动的严重程度和不均匀性]。
Pub Date : 1986-03-01
A Takarada, Y Yokota, T Kumaki, T Seo, M Kubo, N Maehashi, O Nakanishi, M Hayakawa, T Inoh, H Fukuzaki

A two and a half year follow-up study of segmental left ventricular wall motion was performed by two-dimensional echocardiography for 26 patients with dilated cardiomyopathy (DCM). Segmental analysis of left ventricular wall motion abnormalities (WMA) was performed using 11 segments obtained by short- and long-axis views of the left ventricle. Wall motion in each segment was classified and assigned a numerical score as normal (0), hypokinetic (1), severely hypokinetic (2), and akinetic or dyskinetic (3). Based on this categorization, a wall motion abnormality index (WMAI) was derived as an overall assessment of left ventricular asynergy. The intersegmental standard deviation of the wall motion abnormality score was used as an index of left ventricular asynergy (non-uniformity index: NUI). During the follow-up period, the wall motion abnormality index increased in all of the 26 patients (from 1.23 to 1.82, p less than 0.001), but the non-uniformity index did not change (from 0.72 to 0.73). When comparing the non-uniformity index among three groups classified according to the grade of wall motion abnormality, both at the initial and during follow-up studies, the moderate wall motion abnormality group (1.0 less than or equal to WMAI less than 2.0) had larger non-uniformity indexes (0.83, 0.84) than the other groups, and the severe non-uniformity index (greater than or equal to 0.9) was observed solely in the moderate group. In the follow-up study, these 26 patients were categorized in two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

本文对26例扩张型心肌病(DCM)患者进行了为期两年半的二维超声心动图随访研究。左心室壁运动异常(WMA)的节段分析使用左心室短轴和长轴视图获得的11节段。对每节段的壁运动进行分类,并给予数值评分,分为正常(0)、运动不足(1)、严重运动不足(2)、运动不足或运动不足(3)。基于这种分类,得出壁运动异常指数(WMAI),作为左室无能性的总体评估。采用壁运动异常评分的节段间标准差作为左室无能性的指标(non-uniformity index: NUI)。随访期间,26例患者的壁运动异常指数均增加(从1.23增加到1.82,p < 0.001),但不均匀性指数没有变化(从0.72增加到0.73)。在比较按壁运动异常分级的三组不均匀性指数时,无论是初始研究还是随访研究,均发现中度壁运动异常组(1.0小于等于WMAI小于2.0)的不均匀性指数(0.83、0.84)高于其他组,只有中度壁运动异常组出现严重不均匀性指数(大于等于0.9)。在随访研究中,将26例患者分为两组。(摘要删节250字)
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引用次数: 0
[Malignant familial cardiomyopathy with sudden death, typical asymmetric septal hypertrophy and dilated cardiomyopathy-like features]. 恶性家族性心肌病伴猝死,典型的不对称间隔肥厚和扩张性心肌病样特征。
Pub Date : 1986-03-01
T Seo, Y Yokota, N Maehashi, A Takarada, M Kubo, S Toh, O Nakanishi, J Masuda, K Fujitani, H Fukuzaki

Twenty-one members of a family were traced for three generations including the propositus, who had typical dilated cardiomyopathy (DCM)-like features. Clinical, radiological, electrocardiographic and echocardiographic examinations were performed for 13 of 16 still living. Five of 21 members died including three of sudden death. Among living 16 members, five had congestive heart failure, greater than grade III of the NYHA, and cardiomegaly on chest radiography in five. Left ventricular hypertrophy, abnormal Q waves, and ST-T changes were observed on electrocardiography in two, five and eight members, respectively. Echocardiography revealed asymmetric septal hypertrophy (ASH) in four, two of whom had systolic anterior motion (SAM) of the mitral valve. Two had features simulating DCM, and five had mitral valve prolapse. Among six patients with ASH or features simulating DCM, four had cardiac catheterization, coronary angiography and endomyocardial biopsy. None had significant coronary stenosis, but all had high left ventricular end-diastolic pressure (LVEDP) (23 +/- 7 mmHg). Endomyocardial biopsy showed moderate myocardial cellular hypertrophy, interstitial myocardial fibrosis, nuclear changes and myocardial disarrangement, with features characteristic of HCM. In this family with malignant HCM, patients had various clinical features including typical HCM, simulated DCM, DCM coexisted with mitral valve prolapse, and sudden death occurred frequently.

我们对一个家族的21名成员进行了三代的追踪,其中包括有典型扩张型心肌病(DCM)样特征的夫妇。16例患者中有13例进行了临床、放射学、心电图和超声心动图检查。21名成员中有5人死亡,其中3人猝死。在活着的16名成员中,5名患有充血性心力衰竭,超过NYHA的III级,5名胸片显示心脏肿大。心电图显示左室肥厚2例,Q波异常5例,ST-T异常8例。超声心动图显示4例不对称室间隔肥厚(ASH),其中2例有二尖瓣收缩前运动(SAM)。2例有类似DCM的特征,5例有二尖瓣脱垂。在6例有ASH或类似DCM特征的患者中,4例进行了心导管穿刺、冠状动脉造影和心内膜活检。没有人有明显的冠状动脉狭窄,但所有人都有高左室舒张末期压(LVEDP) (23 +/- 7 mmHg)。心肌内膜活检显示中度心肌细胞肥大、间质性心肌纤维化、核改变及心肌紊乱,具有HCM的特征。在这个恶性HCM家族中,患者具有典型HCM、模拟DCM、DCM合并二尖瓣脱垂、猝死等多种临床特征。
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引用次数: 0
[Continuous wave Doppler echocardiographic assessment of prosthetic aortic valves]. 连续波多普勒超声心动图评价人工主动脉瓣。
Pub Date : 1986-03-01
A Kisanuki, C Tei, K Arikawa, Y Otsuji, Y Kawazoe, K Natsugoe, H Tanaka, Y Morishita, A Taira

To assess the prosthetic aortic valve functions according to types and sizes of valves, the peak flow velocity was recorded by means of continuous wave Doppler echocardiography in 40 patients (age 45 +/- 15 years) with prosthetic aortic valves and in 25 normal subjects. Twenty-one patients had Björk-Shiley valves (1-18 months after replacement); 12 had St. Jude Medical valves (6-48 months after replacement); and seven had Carpentier-Edwards porcine xenografts (48-84 months after replacement). The peak blood flow velocity across the prosthetic valve was recorded at the left ventricular apex, the suprasternal notch, and the right parasternal border in the second intercostal space. The pressure gradient was derived from the peak flow velocity by means of the simplified Bernoulli equation (P = 4V2). The peak and mean flow velocities and the peak and mean pressure gradients were measured to evaluate the opening function of the prosthetic valves. The results were as follows; The peak flow velocities were recorded in 33 patients (83%) with aortic valve replacements. All four measurements were significantly greater in patients with prosthetic aortic valves than in normal subjects, but there was no significant difference according to the valve type. The opening function was less in patients with smaller valves than in those with larger ones. There was a clear correlation between opening function and valve size. We concluded that continuous wave Doppler echocardiography is a useful noninvasive method for evaluating the opening function of a prosthetic aortic valve.

采用连续波多普勒超声心动图记录40例(年龄45 +/- 15岁)人工主动脉瓣患者和25例正常人的峰值血流速度,根据瓣膜的类型和大小评价人工主动脉瓣的功能。21例患者置换术后1-18个月植入Björk-Shiley瓣膜;12例有St. Jude Medical瓣膜(置换术后6-48个月);7例移植卡彭迪埃-爱德华兹猪(48-84个月)。在左心室顶点、胸骨上切迹和第二肋间隙右胸骨旁边界处记录了人工瓣膜的血流速度峰值。压力梯度由峰值流速根据简化伯努利方程(P = 4V2)推导。测量峰值流速和平均流速、峰值压力梯度和平均压力梯度,评价人工瓣膜的开启功能。实验结果如下:在33例(83%)主动脉瓣置换术患者中记录了峰值血流速度。人工主动脉瓣患者的四项指标均显著高于正常受试者,但瓣膜类型没有显著差异。瓣膜小的患者的开启功能比瓣膜大的患者差。开启功能与阀门通径有明显的相关性。我们的结论是,连续波多普勒超声心动图是评估人工主动脉瓣开放功能的一种有用的无创方法。
{"title":"[Continuous wave Doppler echocardiographic assessment of prosthetic aortic valves].","authors":"A Kisanuki,&nbsp;C Tei,&nbsp;K Arikawa,&nbsp;Y Otsuji,&nbsp;Y Kawazoe,&nbsp;K Natsugoe,&nbsp;H Tanaka,&nbsp;Y Morishita,&nbsp;A Taira","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To assess the prosthetic aortic valve functions according to types and sizes of valves, the peak flow velocity was recorded by means of continuous wave Doppler echocardiography in 40 patients (age 45 +/- 15 years) with prosthetic aortic valves and in 25 normal subjects. Twenty-one patients had Björk-Shiley valves (1-18 months after replacement); 12 had St. Jude Medical valves (6-48 months after replacement); and seven had Carpentier-Edwards porcine xenografts (48-84 months after replacement). The peak blood flow velocity across the prosthetic valve was recorded at the left ventricular apex, the suprasternal notch, and the right parasternal border in the second intercostal space. The pressure gradient was derived from the peak flow velocity by means of the simplified Bernoulli equation (P = 4V2). The peak and mean flow velocities and the peak and mean pressure gradients were measured to evaluate the opening function of the prosthetic valves. The results were as follows; The peak flow velocities were recorded in 33 patients (83%) with aortic valve replacements. All four measurements were significantly greater in patients with prosthetic aortic valves than in normal subjects, but there was no significant difference according to the valve type. The opening function was less in patients with smaller valves than in those with larger ones. There was a clear correlation between opening function and valve size. We concluded that continuous wave Doppler echocardiography is a useful noninvasive method for evaluating the opening function of a prosthetic aortic valve.</p>","PeriodicalId":77734,"journal":{"name":"Journal of cardiography","volume":"16 1","pages":"121-32"},"PeriodicalIF":0.0,"publicationDate":"1986-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14901252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Mitral valve prolapse with myocardial disarrangement and familial hypertrophic cardiomyopathy: a case report]. 二尖瓣脱垂合并心肌功能障碍和家族性肥厚性心肌病1例。
Pub Date : 1986-03-01
T Kumaki, Y Yokota, K Okamoto, A Takarada, T Seo, N Maehashi, S Toyama, H Fukuzaki

This is a report of a patient with mitral valve prolapse (MVP) and myocardial abnormalities on endomyocardial biopsy in whose relatives hypertrophic cardiomyopathy (HCM) was identified. A 19-year-old woman was admitted to our hospital for evaluation of a heart murmur. A systolic ejection murmur was audible in the third intercostal space at the left sternal border, and a standard 12-lead electrocardiogram showed ST-T wave changes in leads II, III and aVF. Echocardiography revealed prolapse of the anterior leaflet of the mitral valve, but no left ventricular hypertrophy. Endomyocardial biopsy disclosed mild hypertrophy and disarrangement of the myocardium. The family study revealed asymmetrical septal hypertrophy in her mother, who had no history of hypertension. Her younger sister had mild hypertrophy of the interventricular septum on echocardiography, and her histopathological findings suggested a diagnosis of HCM. This case was clinically regarded as MVP, but development of left ventricular hypertrophy as noted in her mother may occur in the future.

这是一个报告的患者二尖瓣脱垂(MVP)和心肌内膜活检的心肌异常,其亲属是肥厚性心肌病(HCM)。一名19岁女子因心脏杂音入院。左胸骨边界第三肋间隙可听到收缩期射血杂音,标准12导联心电图显示II、III和aVF导联ST-T波改变。超声心动图显示二尖瓣前小叶脱垂,但未见左室肥厚。心内膜活检显示心肌轻度肥大和紊乱。家庭研究显示,她的母亲没有高血压病史,但鼻中隔肥厚不对称。她的妹妹在超声心动图上有轻微的室间隔肥大,她的组织病理学结果提示HCM的诊断。该病例在临床上被认为是MVP,但如其母亲所见的左心室肥厚可能在未来发生。
{"title":"[Mitral valve prolapse with myocardial disarrangement and familial hypertrophic cardiomyopathy: a case report].","authors":"T Kumaki,&nbsp;Y Yokota,&nbsp;K Okamoto,&nbsp;A Takarada,&nbsp;T Seo,&nbsp;N Maehashi,&nbsp;S Toyama,&nbsp;H Fukuzaki","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This is a report of a patient with mitral valve prolapse (MVP) and myocardial abnormalities on endomyocardial biopsy in whose relatives hypertrophic cardiomyopathy (HCM) was identified. A 19-year-old woman was admitted to our hospital for evaluation of a heart murmur. A systolic ejection murmur was audible in the third intercostal space at the left sternal border, and a standard 12-lead electrocardiogram showed ST-T wave changes in leads II, III and aVF. Echocardiography revealed prolapse of the anterior leaflet of the mitral valve, but no left ventricular hypertrophy. Endomyocardial biopsy disclosed mild hypertrophy and disarrangement of the myocardium. The family study revealed asymmetrical septal hypertrophy in her mother, who had no history of hypertension. Her younger sister had mild hypertrophy of the interventricular septum on echocardiography, and her histopathological findings suggested a diagnosis of HCM. This case was clinically regarded as MVP, but development of left ventricular hypertrophy as noted in her mother may occur in the future.</p>","PeriodicalId":77734,"journal":{"name":"Journal of cardiography","volume":"16 1","pages":"227-36"},"PeriodicalIF":0.0,"publicationDate":"1986-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14901217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Reversed Hegglin syndrome in Takayasu arteritis]. [高须动脉炎的逆转Hegglin综合征]。
Pub Date : 1986-03-01
T Fujiwara, T Sawayama, S Yamamoto, S Nezuo, K Hasegawa, M Samukawa, Y Harada, S Kakumae, T Nakamura

To study the "reversed Hegglin syndrome" in Takayasu arteritis, 57 patients were selected, and divided into four groups; Group I: 12 with Takayasu arteritis with aortic regurgitation (AR), Group II: 27 with Takayasu arteritis without AR, Group III: six with annuloaortic ectasia and severe AR, and Group IV: 12 with severe AR of other miscellaneous etiologies. QII-QT intervals were compared among the four groups. The reversed Hegglin syndrome (QII-QT greater than or equal to 40 msec) was observed in 58 percent of Group I patients and 37 percent of Group II patients. This phenomenon was not seen in any patients in Group III or IV. Sixteen of the 17 patients who had the reversed Hegglin syndrome belonged to the thoracic aortic type or diffuse type of Takayasu arteritis. Most patients who did not have this syndrome either had a localized lesion or a prolonged QT interval. The reversed Hegglin syndrome, therefore, is related to widespread lesions involving the thoracic aorta due to Takayasu arteritis, and may be attributed to a delay in closure of the aortic second heart sound due to a decrease in aortic impedance of the diseased proximal aorta.

为研究高须动脉炎的“逆转Hegglin综合征”,选择57例患者,分为4组;ⅰ组:高松动脉炎合并主动脉反流(AR) 12例,ⅱ组:无AR的高松动脉炎27例,ⅲ组:主动脉环扩张合并重度AR 6例,ⅳ组:其他多种病因合并重度AR 12例。比较四组患者的qi - qt间期。在58%的I组患者和37%的II组患者中观察到逆转Hegglin综合征(qi - qt大于或等于40毫秒)。III组和IV组均未见此现象。17例Hegglin综合征逆转患者中有16例属于胸主动脉型或弥漫性高松动脉炎。大多数没有这种综合征的患者要么有局部病变,要么有延长的QT间期。因此,逆转Hegglin综合征与Takayasu动脉炎引起的胸主动脉广泛病变有关,可能是由于病变近端主动脉的主动脉阻抗降低,导致主动脉第二心音关闭延迟。
{"title":"[Reversed Hegglin syndrome in Takayasu arteritis].","authors":"T Fujiwara,&nbsp;T Sawayama,&nbsp;S Yamamoto,&nbsp;S Nezuo,&nbsp;K Hasegawa,&nbsp;M Samukawa,&nbsp;Y Harada,&nbsp;S Kakumae,&nbsp;T Nakamura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To study the \"reversed Hegglin syndrome\" in Takayasu arteritis, 57 patients were selected, and divided into four groups; Group I: 12 with Takayasu arteritis with aortic regurgitation (AR), Group II: 27 with Takayasu arteritis without AR, Group III: six with annuloaortic ectasia and severe AR, and Group IV: 12 with severe AR of other miscellaneous etiologies. QII-QT intervals were compared among the four groups. The reversed Hegglin syndrome (QII-QT greater than or equal to 40 msec) was observed in 58 percent of Group I patients and 37 percent of Group II patients. This phenomenon was not seen in any patients in Group III or IV. Sixteen of the 17 patients who had the reversed Hegglin syndrome belonged to the thoracic aortic type or diffuse type of Takayasu arteritis. Most patients who did not have this syndrome either had a localized lesion or a prolonged QT interval. The reversed Hegglin syndrome, therefore, is related to widespread lesions involving the thoracic aorta due to Takayasu arteritis, and may be attributed to a delay in closure of the aortic second heart sound due to a decrease in aortic impedance of the diseased proximal aorta.</p>","PeriodicalId":77734,"journal":{"name":"Journal of cardiography","volume":"16 1","pages":"141-7"},"PeriodicalIF":0.0,"publicationDate":"1986-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14901254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Noninvasive and Quantitative Evaluation of the Severity of Isolated Pulmonary Valvular Stenosis by Two-Dimensional Pulsed Doppler Echocardiography 二维脉冲多普勒超声心动图对孤立性肺动脉瓣狭窄严重程度的无创定量评价
Pub Date : 1986-01-01 DOI: 10.1007/978-1-4613-8598-1_105
A. Ishizawa, M. Nishida, J. Kobayashi, T. Ninomiya, M. Ikuma, Y. Igarashi, T. Yamaguchi
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引用次数: 0
[Pulmonary regurgitation with special reference to the shape of the pulmonary valve ring: a pulsed Doppler and angiographic study]. [肺动脉瓣环形状的肺返流:脉冲多普勒和血管造影研究]。
Pub Date : 1985-12-01
H Tsuneyoshi, K Hara, H Takeuchi, M Kashida, T Yamaguchi, H Toide, E Toda, K Machii

Using pulsed Doppler echocardiography and cineangiography, the significance of pulmonic valve ring dimensions in the genesis of pulmonic regurgitation (PR) was studied in 40 patients, including 12 with valvular disease, 19 with coronary artery disease and nine with the normal heart. In nine of the 40 subjects, pulmonary hypertension (mean pulmonary artery pressure greater than or equal to 20 mmHg) was observed. The criterion for diagnosing PR was disturbed flow patterns recorded just below the pulmonic valve which spanned more than 40% of diastole, exceeding 1.5 KHz in peak frequency (corresponding to a flow velocity of about 50 cm/sec). Sagittal and transverse diameters of the pulmonic valve ring (PRDs, PRDt) at the upper edge of the pulmonary sinus, and the sagittal diameter of the pulmonary sinus (PSD) at the level of its maximal bulging were measured using pulmonary angiography. PR was detected in 15 subjects (37.5%). The prevalence of PR among three groups regardless of the absence or presence of pulmonary hypertension was not significantly different. The peak frequency of the regurgitant flow signals as well as the farthest point of the signals detected did not differ among the three groups irrespective of pulmonary hypertension. The ratio of the PRDs to the PRDt (PRDs/PRDt) was greater in patients with PR than in those without PR (p less than 0.001), but no correlation was established between PRDs/PRDt and mean pulmonary artery pressure. The PRDt index and PRDs index (normalized by body surface area) correlated well with the mean pulmonary artery pressure (r = 0.70, p less than 0.001 and r = 0.62, p less than 0.001, respectively). PSD also correlated with the mean pulmonary artery pressure (r = 0.49, p less than 0.01), whereas, PSD/PRDs correlated inversely with the mean pulmonary artery pressure (r = 0.40, p less than 0.01), indicating a relatively more prominent dilatation of the PRDs than of the PSD in cases with pulmonary hypertension. These results suggest that the etiology of PR in our series of patients was primarily attributable to the distortion of the pulmonic valve ring. The wide-spread concept that pulmonary hypertension dilates the pulmonic valve ring, leading to the development of PR, should be criticized.

应用脉冲多普勒超声心动图和血管造影技术,对40例肺动脉瓣环尺寸在肺动脉反流(PR)发生中的意义进行了研究,其中瓣膜病12例,冠心病19例,正常心脏9例。40例受试者中有9例出现肺动脉高压(平均肺动脉压大于或等于20 mmHg)。诊断PR的标准是记录在肺动脉瓣下方的干扰血流模式,超过舒张期的40%,峰值频率超过1.5 KHz(对应于大约50厘米/秒的流速)。肺动脉造影测量肺窦上缘肺动脉瓣环(PRDs, PRDt)矢状径和横径,以及肺窦最大膨出水平的矢状径(PSD)。PR检出15例(37.5%)。无论是否存在肺动脉高压,三组间PR的患病率无显著差异。反流信号的峰值频率以及检测到的信号的最远点在三组之间没有差异,与肺动脉高压无关。PR患者PRDs/PRDt比值大于无PR患者(p < 0.001),但PRDs/PRDt与平均肺动脉压之间无相关性。PRDt指数和PRDs指数(按体表面积归一化)与平均肺动脉压相关性较好(r = 0.70, p < 0.001)。PSD与平均肺动脉压相关(r = 0.49, p < 0.01),而PSD/PRDs与平均肺动脉压呈负相关(r = 0.40, p < 0.01),说明肺动脉高压患者PRDs扩张较PSD明显。这些结果表明,在我们的一系列患者中,PR的病因主要是由于肺动脉瓣环的扭曲。肺动脉高压扩张肺动脉瓣环,导致PR的发展,这种广为流传的观念应该受到批评。
{"title":"[Pulmonary regurgitation with special reference to the shape of the pulmonary valve ring: a pulsed Doppler and angiographic study].","authors":"H Tsuneyoshi,&nbsp;K Hara,&nbsp;H Takeuchi,&nbsp;M Kashida,&nbsp;T Yamaguchi,&nbsp;H Toide,&nbsp;E Toda,&nbsp;K Machii","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Using pulsed Doppler echocardiography and cineangiography, the significance of pulmonic valve ring dimensions in the genesis of pulmonic regurgitation (PR) was studied in 40 patients, including 12 with valvular disease, 19 with coronary artery disease and nine with the normal heart. In nine of the 40 subjects, pulmonary hypertension (mean pulmonary artery pressure greater than or equal to 20 mmHg) was observed. The criterion for diagnosing PR was disturbed flow patterns recorded just below the pulmonic valve which spanned more than 40% of diastole, exceeding 1.5 KHz in peak frequency (corresponding to a flow velocity of about 50 cm/sec). Sagittal and transverse diameters of the pulmonic valve ring (PRDs, PRDt) at the upper edge of the pulmonary sinus, and the sagittal diameter of the pulmonary sinus (PSD) at the level of its maximal bulging were measured using pulmonary angiography. PR was detected in 15 subjects (37.5%). The prevalence of PR among three groups regardless of the absence or presence of pulmonary hypertension was not significantly different. The peak frequency of the regurgitant flow signals as well as the farthest point of the signals detected did not differ among the three groups irrespective of pulmonary hypertension. The ratio of the PRDs to the PRDt (PRDs/PRDt) was greater in patients with PR than in those without PR (p less than 0.001), but no correlation was established between PRDs/PRDt and mean pulmonary artery pressure. The PRDt index and PRDs index (normalized by body surface area) correlated well with the mean pulmonary artery pressure (r = 0.70, p less than 0.001 and r = 0.62, p less than 0.001, respectively). PSD also correlated with the mean pulmonary artery pressure (r = 0.49, p less than 0.01), whereas, PSD/PRDs correlated inversely with the mean pulmonary artery pressure (r = 0.40, p less than 0.01), indicating a relatively more prominent dilatation of the PRDs than of the PSD in cases with pulmonary hypertension. These results suggest that the etiology of PR in our series of patients was primarily attributable to the distortion of the pulmonic valve ring. The wide-spread concept that pulmonary hypertension dilates the pulmonic valve ring, leading to the development of PR, should be criticized.</p>","PeriodicalId":77734,"journal":{"name":"Journal of cardiography","volume":"15 4","pages":"1145-56"},"PeriodicalIF":0.0,"publicationDate":"1985-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14957937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of cardiography
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