真田 純一, 中村 一彦, 南 幸弘, 窪 博道, 川平 正純, 黒岩 宣親, 大重 太真男, 橋本 修治

Jun-ichi Sanada, Kazuhiko Nakamura, Yukihiro Minami, Hiromichi Kubo, Masazumi Kawahira, , Tamao Ohshige, Shuji Hashimoto

鹿児島大学医学部第二内科

The 2nd Dept,of Internal Medicine, School of Medicine, Kagoshima Univ.

キーワード : mitral regurgitation, pulsed Doppler echocardiography, disturbed flow, abnormal systolic backward flow, isovolumetric contraction flow

　The usefulness of pulsed Doppler echocardiography for detection and evaluation of severity of mitral regurgita- tion was studied in 74 consecutive patients undergoing left ventriculography and ll healthy subjects. Mitral regurgitation was confirmed in 26 cases by left ventriculography. In 22 of 26 cases of mitral regurgitation, systolic disturbed flow in the left atrial cavity was detected by pulsed Doppler echocardiography, however, that could not be detected in the other 4 cases (Sellers I : 4 cases). There were no false positives. Thus, the sensitivity was 85%and the specificity was 100%. Near the mitral orifice in the left ventricular inflow tract, abnormal systolic laminar forward flow, which began already at the isovolumetric contraction phase and had the peak of velocity in latesystole, was observed in 7 cases (Sellers IIO: 5 cases, IVO: 2 cases). Furthermore, precipitous brief laminar forward flow caused by isovolumetric contraction in the left ventricular outflow tract was extremely diminished or disappeared in all but one of the III and IV cases. These findings were considered to indicate the high-grade mitral regurgitation, because they could not be detected in the cases with low-grade mitral regurgitation such as Sellers I and IIO. Thus, pulsed Doppler echocardiography appears to be useful technique for detection and evaluation of severity of mitral regurgitation.