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英文誌(2004-)

Journal of Medical Ultrasonics

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1993 - Vol.20

Vol.20 No.02

Original Article(原著)

(0095 - 0102)

高血圧心における肺静脈血流速波形の解析:左室流入血流速波形の解釈に際しての臨床的意義

Pulmonary Venous Flow Velocity Patterns Provide Useful Information in the Interpretation of Mitral Flow Velocity Patterns in Hypertensive Patients

李 正明1, 永野 玲子2, 増山 理2, 成山 和功1, 大荒 貞男1, 杉原 逸朗1, 高橋 宏1, 中村 幸二1

Jung-Myung LEE1, Reiko NAGANO2, Tohru MASUYAMA2, Kazunori NARIYAMA1, Sadao OOARA1, Itsurou SUGIHARA1, Hiroshi TAKAHASHI1, Kouji NAKAMURA1

1市立貝塚病院内科, 2大阪大学医学部第1内科

1Department of Internal Medicine, Kaizuka Municipal Hospital, 2The First Department of Medicine, Osaka University School of Medicine

キーワード : Hypertension, Pulsed Doppler, Pulmonary venous flow velocity

Although the Doppler mitral flow velocity pattern changes in accordance with the degree of left ventricular diastolic dysfunction, it is "normalized" in the presence of heart failure. In this study the pulmonary venous flow velocity pattern was characterized in 60 hypertensive patients with and without heart failure to clarify whether analysis of the pulmonary venous flow velocity pattern provides complementary information in the interpretation of the mitral flow velocity pattern. The mitral flow velocity pattern in 42 hypertensive patients without heart failure was characterized by decreases in the peak early diastolic filling velocity (E) and increases in the ratio of peak filling velocity at atrial contraction to E. The mitral flow velocity pattern was "normalized" in 18 patients with heart failure, without any differences in the indexes of the mitral flow velocity pattern as compared to 24 normals. The pulmonary venous flow velocity pattern in hypertensive patients without heart failure was characterized by decreases in the peak diastolic forward flow velocity (D) and increases in the ratio of peak systolic forward flow velocity (S) to D(S/D ratio). In patients with heart failure, D was higher and the S/D ratio was lower compared to hypertensive patients without heart failure (pConclusions: The pulmonary venous flow velocity pattern in hypertensive patients without heart failure was characterized by decreases in D and increases in the S/D ratio. The characteristic abnormal pattern was "supernormalized" in association with heart failure. Thus, pulmonary venous flow velocity patterns appeared to be more reliable than mitral flow velocity patterns in differentiating subgroups of hypertensive patients. Analysis of pulmonary venous flow velocity patterns in conjunction with mitral flow velocity patterns provides a useful information in the interpretation of mitral flow velocity patterns in hypertensive patients with and without heart failure.