佐野 俊二, 紀 幸一, 今吉 英介, 米花 正晴, 名和 清人, 妹尾 嘉昌, 寺本 滋

Shunji SANO, Kouichi KINO, Eisuke IMAYOSHI, Masaharu BEIKA, Sugato NAWA, Yoshimasa SENOO, Shigeru TERAMOTO

岡山大学医学部第二外科

The 2nd Department of Surgery, Okayama University

キーワード : the left ventricular reserve, dynamic exercise, valvular heart disease, %ΔSI

To evaluate the left ventricular reserve, the dynamic ergometer exercise echocardiography was performed on 64 cases of valvular heart diseases which were operated on during the period from January 1979 to July 1981 in Okayama University Hospital.
The dynamic exercise echocardiographic study demonstrated that the left ventricular reserve of MS-MVR, MSR and MR groups was more depressed than that of MS-MC, AS and AR groups.
According to the rate of exercise-induced percent increase in stroke index, which represents cardiac pump function, all cases of each group were divided into three subgroups, increase (%ΔSI ≥ 10%) no change (-10% < %ΔSI < 10%) and decrease (%ΔSI ≤ -10%). The former two subgroups could be discriminated from the latter subgroup by Y = -6.86X-4.76 when percent increase in mVcf (%ΔmVcf) and Dd (%ΔDd) during exercise were plotted on XY coordinate.
Applying the dynamic echocardiography, the left ventricular reserve was exactly assessed, and the relationships among the reserve of the left ventricular pump function (ΔSI), the reserve of the myocardial contractility (ΔmVcf) and the reserve to the increase in preload (ΔDd) were clarified. Besides, the post-operative subclinical failing heart would be detected by this maneuver.