冠心病患者静息和运动时的右心室功能。

European journal of cardiology Pub Date : 1980-02-01
K R Karsch, S Scheufler, H Blanke, P Rentrop
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摘要

本文对16例右冠状动脉狭窄大于50%和小于90%的患者进行静息和运动时的右心室双平面影室图,以解释运动性心绞痛时右心室容量和功能的改变。右心室舒张末期容积从113 +/- 6.6 ml/m2增加到133.9 +/- 9.8 ml/m2 (P < 0.001)。收缩期容积从48.9 +/- 4.1 ml/m2增加到52.9 +/- 5.3 ml/m2。卒中容积指数从64 +/- 5.5 ml/m2增加到81 +/-8.3 ml/m2 (P < 0.001)。同时,射血分数由56.5 +/- 2.9%上升至60.2 +/- 3.2% (P < 0.05)。左室舒张压由12.8 +/- 1.5 mm Hg升高至26.6 +/- 1.6 mm Hg (P < 0.001)。右心室舒张压由5.8 +/- 0.5升高至12.2 +/- 0.8 mm Hg (P < 0.001)。平均直径缩短速度VD由0.9 +/- 0.06 D/s增加到1.12 +/- 0.09 D/s (P < 0.05)。运动性心绞痛导致左心室舒张压显著升高,从而导致右心室后负荷升高。右冠状动脉狭窄患者后负荷的增加可通过舒张期容积的显著增加得到补偿:运动诱发心绞痛时的泵功能是通过增加前负荷来维持的。
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Right ventricular function at rest and during exercise in patients with coronary heart disease.

Biplane cineventriculograms of the right ventricle at rest and during exercise were made of 16 patients with a right coronary artery stenosis of greater than 50% and less than 90% to explain the alteration of the volumes and function of the right ventricle during exercise-induced angina pectoris. The right ventricular enddiastolic volume increases from 113 +/- 6.6 ml/m2 to 133.9 +/- 9.8 ml/m2 (P less than 0.001). The endsystolic volume increases from 48.9 +/- 4.1 ml/m2 to 52.9 +/- 5.3 ml/m2. The stroke volume index increases from 64 +/- 5.5 ml/m2 to 81 +/-8.3 ml/m2 (P less than 0.001). At the same time the ejection fraction increases from 56.5 +/- 2.9% to 60.2 +/- 3.2% (P less than 0.05). The left ventricular enddiastolic pressure increases from 12.8 +/- 1.5 mm Hg to 26.6 +/- 1.6 mm Hg (P less than 0.001). The enddiastolic pressure of the right ventricle increases from 5.8 +/- 0.5 to 12.2 +/- 0.8 mm Hg (P less than 0.001). The mean velocity of diameter shortening, VD, increases from 0.9 +/- 0.06 D/s to 1.12 +/- 0.09 D/s (P less than 0.05). Exercise-induced angina pectoris leads to a considerable increase of the left ventricular enddiastolic pressure and therefore to an increase of the right ventricular afterload. The increase of afterload in patients with a right coronary artery stenosis is compensated by a considerable increase of the enddiastolic volume: the pump-function during exercise-induced angina pectoris is maintained by an increase of preload.

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