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Journal of Medical Ultrasonics

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1993 - Vol.20

Vol.20 No.08

Original Article(原著)

(0476 - 0481)


The Left Atrial Function in Patients with Pseudonormalized Left Ventricular Inflow Pattern

本藤 達也1, 片山 恵子1, 川本 敏雄1, 岡本 光師2, 唐川 真二3, 松浦 秀夫3, 梶山 梧郎3

Tatsuya HONDO1, Keiko KATAYAMA1, Toshio KAWAMOTO1, Mitsunori OKAMOTO2, Sinji KARAKAWA3, Hideo MATSUURA3, Goro KAJIYAMA3

1三菱三原病院内科, 2県立広島病院第1内科, 3広島大学第1内科

1Department of Internal Medicine, Mitsubishi Mihara Hospital, 2The First Department of Internal Medicine, Hiroshima Prefectural Hospital, 3The First Department of Internal Medicine, Hiroshima University School of Medicine

キーワード : Pseudonormalized left ventricular inflow pattern, Left atrial function, Afterload echocardiography, Apexcardiogram

Left atrial contribution decreases “paradoxically” in some patients with severe left ventricular dysfunction (pseudonormalized left ventricular inflow pattern). Although it is thought that the decreased left atrial contribution may be caused by atrial failure or atrial afterload mismatch, the mechanism has been remained unclear. The relationship between “a wave ratio” of apexcardiogram and mean velocity of left atrial dimensional shortening (mean Vd) was evaluated in 9 normal subjects (group N), 6 patients with pseudonormalized inflow pattern (group P), and the other 28 patients with heart diseases (group D). The peak velocity during the atrial contraction phase in group P was significantly lower than those in group N (p-1, group D; 1.0±0.4 sec-1, group P; 0.5±0.1 sec-1). However, left atrial contractility in group P was not attenuated as assessed by mean Vd-“a wave ratio” relationship. This suggests that atrial afterload mismatch may be one of the major determinants of decreased atrial contribution in group P.