島本 博幸, 岡本 光師, 佐倉 英一郎, 横手 祐司, 橋本 正樹, 山形 東吾, 網岡 英世, 高橋 路子, 土岡 由紀子, 松浦 秀夫, 梶山 梧朗

Hiroyuki SHIMAMOTO, Mitsunori OKAMOTO, Eiichiro SAKURA, Yuji YOKOTE, Masaki HASHIMOTO, Togo YAMAGATA, Hideyo AMIOKA, Michiko TAKAHASHI, Yukiko TSUCHIOKA, Hideo MATSUURA, Goro KAJIYAMA

広島大学医学部第一内科

The First Department of Internal Medicine, Hiroshima University School of Medicine

キーワード : Mitral valve movement, Transmitral flow, Radionuclide angiography

The relationship of transmitral flow by pulsed Doppler echocardiography and diastolic left ventricular filling by radionuclide angiography to the anterior mitral valve echogram was investigated in 54 subjects without mitral valvular disease. Transmitral flow was obtained from the apical long axis view and the mitral valve echograms from the parasternal approach. Though there was some similarity in configuration between the mitral flow pattern and the mitral valve movement, these two were not quite the same. The mean acceleration and deceleration rate in the rapid filling phase (ACR, DCR) and the ratio of the peak flow velocity in the atrial contraction phase to that in the rapid filling phase (A/R) were rather poorly correlated with respective corresponding values from the anterior mitral valve echogram. (ACR vs opening velocity: r=0.50, DCR vs DDR: r=0.48, A/R vs A/E: r=0.46).
While, A/R obtained by Doppler echocardiography showed good correlation with the ratio of the peak filling rate during rapid filling and during atrial systole (A/R) (r=0.76).
These results indicate that diastolic volume changes of the left ventricle reflect the mitral flow pattern rather than the mitral echogram, because the mitral valve echogram may also be influenced by such other factors as the changes of blood flow directions against the mitral valve, vortices behind the mitral valve, and posterior movement of the whole heart during diastole.