NONINVASIVE EVALUATION OF THE INFLUENCE OF AORTIC WAVE REFLECTION ON LEFT-VENTRICULAR EJECTION DURING AUXOTONIC CONTRACTION

被引：33

作者：

MIYASHITA, H

IKEDA, U

TSURUYA, Y

SEKIGUCHI, H

SHIMADA, K

YAGINUMA, T

机构：

[1] Department of Cardiology, Jichi Medical School, Tochigi, 329-04, Minamikawachi-machi

[2] Department of Medicine, Oomiya Medical Center of Jichi Medical School, Oomiya, 330, Amanuma-chou

来源：

HEART AND VESSELS | 1994年 / 9卷 / 01期

关键词：

PULSED DOPPLER; CAROTID AUGMENTATION INDEX; AORTIC WAVE REFLECTION; LEFT VENTRICULAR AFTERLOAD; VASODILATOR AGENTS;

D O I：

10.1007/BF01744493

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

To develop a noninvasive method for evaluating the influence of aortic wave reflection on left ventricular ejection, the carotid pulse wave and the pulsed Doppler wave in the left ventricular outflow tract were evaluated in 35 patients. Agreement between the pulsed Doppler waveform and the aortic flow velocity contour (obtained invasively) was verified by Fourier analysis. The carotid augmentation index was used to determine the magnitude of the aortic pressure wave reflection. A Doppler index named ''DRI/3'' was defined as the ratio of deceleration at the first one-third in the deceleration phase to the peak flow velocity of the pulsed Doppler. This index was validated by close correlation with the carotid augmentation index (n = 48, r = 0.70, P < 0.01). Both nitrates and nifedipine induced a significant decrease in DR1/3 (indicating an increase in left ventricular ejection flow) in relation to a reduction of the reflected pressure wave. The new noninvasive index, DR1/3, is useful in evaluating the influence of aortic wave reflection as part of the left ventricular afterload and in assessing the benefit of treatment aimed at reducing wave reflection.

引用

页码：30 / 39

页数：10

共 33 条

[11]

Kelly R.P., Gibbs H.H., O'Rourke M.F., Daley J.E., Mang K., Morgan J.J., Avolio A.P., Nitroglycerin has more favourable effects on left ventricular afterload than apparent from measurement of pressure in a peripheral artery, Eur Heart J, 11, pp. 138-144, (1990)

[12]

Fujii M., Yaginuma T., Takazawa K., Noda T., Komatsu H., Katsuki T., Watabiki H., Kawada Y., Hosoda S., Non-invasive detection for reflection wave in the arterial system, Automedica, vol 9, (1987)

[13]

Kelly R., Hayward C., Avolio A., O'Rourke M., Noninvasive determination of age-related changes in the human arterial pulse, Circulation, 80, pp. 1652-1659, (1989)

[14]

Kelly R., Fitchett D., Noninvasive aortic input impedance and external left ventricular power output: A validation and repeatability study of a new technique, J Am Coll Cardiol, 20, pp. 952-963, (1992)

[15]

Brin K.P., Yin F.C.P., Effect of nitroprusside on wave reflections in patients with heart failure, Ann Biomed Eng, 12, pp. 135-150, (1984)

[16]

Bland J.M., Altman D.G., Statistical methods for assessing agreement between two methods of clinical measurement, Lancet, 1, pp. 307-10, (1986)

[17]

Dubin J., Wallerson D.C., Cody R.J., Devereux R.B., Comparative accuracy of Doppler echocardiographic methods for clinical stroke volume determination, Am Heart J, 120, pp. 116-23, (1990)

[18]

Yaginuma T., Noda T., Tsuchiya M., Takazawa K., Tanaka H., Kotohda K., Interaction of left ventricular contraction and aortic input impedance in experimental and clinical studies, Jpn Circ J, 49, pp. 206-214, (1985)

[19]

Milnor W.R., Arterial impedance as ventricular afterload, Circ Res, 36, pp. 565-570, (1975)

[20]

Nichols W.W., Pepine C.J., Left ventricular afterload and aortic input impedance: Implications of pulsatile blood flow, Prog Cardiovasc Dis, 24, pp. 293-306, (1982)

← 1 2 3 4 →