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英文誌(2004-)

Journal of Medical Ultrasonics

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1989 - Vol.16

Vol.16 No.06

Original Article(原著)

(0525 - 0537)

心室中部閉塞性肥大型心筋症の心腔内血流評価:左室壁動態との対比

Relationship between Intracavitary Flow Conditions and Left Ventricular Wall Dynamics in Hypertrophic Cardiomyopathy with Midventricular Obstruction

中村 隆志1, 松原 欣也1, 古川 啓三1, 北村 浩一1, 東 秋弘1, 杉原 洋樹1, 勝目 紘1, 中川 雅夫1, 宮尾 賢爾2

Takashi NAKAMURA1, Kin-ya MATSUBARA1, Keizo FURUKAWA1, Hirokazu KITAMURA1, Akihiro AZUMA1, Hiroki SUGIHARA1, Hiroshi KATSUME1, Masao NAKAGAWA1, Kenji MIYAO2

1京都府立医科大学第二内科, 2京都第二赤十字病院循環器内科

1Second Department of Medicine, Kyoto Prefectural University of Medicine, 2Department of Medicine, Kyoto Second Red Cross Hospital

キーワード : Doppler echocardiography, Hypertrophic cardiomyopathy, Midventricular obstruction, Left ventriculography

Using Doppler echocardiography, intraventricular flow conditions were assessed in 10 cases of hypertrophic cardiomyopathy with midventricular obstruction (MVO). This data was compared with left ventricular wall dynamics obtained using left ventriculography.
Real-time color flow imagings from the apical window revealed that all patients had systolic turbulent flow originating in the obliterated midcavity of the left ventricle. The peak flow velocity at rest ranged from 2.5 to 3.8 m/sec (mean 3.0). In diastole, two types of flow profiles were observed at the midventricle. Five patients with hyperkinetic apical segments had fast flow toward the apex during the rapid filling phase. The peak flow velocity was significantly incrased as compared with peak velocity of transmitral rapid filling flow (112±30 vs 45±9 cm/sec; pIn conclusion, MVO creates pressure gradients between the apex and the base not only in systole but also in early diastole. Obliteration of the midcavity may deteriorate apical wall function, which can be the cause of a curious gradient with higher apical pressure seen in early diastole. Doppler echocardiography is useful in evaluating these abnormal left ventricular dynamics with reference to the intracavitary flow conditions seen in MVO.