Online Journal
IF値: 1.878(2021年)→1.8(2022年)


Journal of Medical Ultrasonics

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1993 - Vol.20

Vol.20 No.05

Original Article(原著)

(0269 - 0276)


Evaluation of Right Ventricular Wall Motion Abnormality During Ischemia by Transveous Intracardiac Echocardiography

鎌田 智彦, 森内 正人, 谷川 直, 神田 章弘, 安藤 輝彦, 斎藤 潁, 小沢 友紀雄, 八杉 忠男

Tomohiko KAMATA, Masahito MORIUCHI, Naoshi TANIGAWA, Akihiro Kanda, Teruhiko ANDO, Satoshi SAITO, Yukio OZAWA, Tadao YASUGI


The Second Department of Internal Medicine, Nihon University School of Medicine

キーワード : Intracardiac ultrasound imaging, Transvenous approach, Right ventricular infarction

Examination of the right ventricle by conventional two-dimentional echocardiography is occasionally problematic. Transvenous intracardiac echocardiography (TVE) may be a useful method for identifying right ventricular wall motion abnormality because of the proximity of the catheter to the right ventricle. A 7 mm transesophageal echoprobe (5 MHz, Aloka inc.) was introduced via the femoral vein and positioned in the right atrium in 10 anesthetized dogs. The probe was rotated and moved back and forth manually to obtain satisfactory images of the right ventricle. Right ventricular ischemia was created by the direct ligation or balloon occlusion of the right coronary artery (n=5). Right ventricular infarction was made by the embolic occlusion of the right coronary artery with a barium-gel mixture through a 6 Fr. coronary catheter (n=5). The entire right ventricle was clearly visualized from multiple views such as long- and short-axis views of the right ventricle and four chamber view. The inflow, anterolateral wall and outflow of the right ventricle were easily visualized using a transverse plane probe. A longitudinal plane prebe was suitable to see the lateral wall. During the transient ischemia, reduced wall motion of the right ventricular free wall and a mild dilatation of the right ventricle were observed in all dogs. In the infarcted dogs, the right ventricular free wall showed akinesis and the interventricular septum demonstrated paradoxical motion. In addition, a marked dilatation of the right ventricle and distortion of the left ventricle were clearly observed in all cases. The time-course of these changes was recorded continuously and successfully. These preliminary results indicate that TVE may be a highly sensitive and useful method for evaluating the right ventricular wall motion abnormality.