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英文誌(2004-)

Journal of Medical Ultrasonics

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1989 - Vol.16

Vol.16 No.01

Original Article(原著)

(0023 - 0030)

ドプラ断層法による永久型ペースメーカー装着後の三尖弁閉鎖不全に関する検討

Evaluation of Tricuspid Regurgitation in Patients with Permanent Pacemaker Using Doppler Color Flow Mapping

大島 寛史1, 桑子 賢司1, 落合 正彦1, 當間 三弘1, 板岡 慶憲1, 吉村 宏1, 原 和弘1, 樫田 光夫1, 山口 徹1, 戸出 浩之2, 遠田 栄一2

Hiroshi OHSHIMA1, Kenji KUWAKO1, Masahiko OCHIAI1, Mitsuhiro TOHMA1, Yoshinori ITAOKA1, Hiroshi YOSHIMURA1, Kazuhiro HARA1, Mitsuo KASHIDA1, Tetsu YAMAGUCHI1, Hiroyuki TOIDE2, Eiichi TOHDA2

1三井記念病院循環器センター内科, 2三井記念病院循環器センター中央検査部

1Center for Cardiovascular Disease Mitsui Memorial Hospital, 2Central Clinical Laboratory, Mitsui Memorial Hospital

キーワード : Permanent pacemaker, Tricuspid regurgitation, Doppler color flow mapping

To evaluate tricuspid regurgitation (TR) in patients with permanent pacemaker (PM), seventy- two patients and thirty-seven normal subjects were examined by Doppler color flow mapping (CFM) and continuous-wave Doppler echocardiography.
Since there existed an excellent correlation between the length and the area of TR signal on Doppler CFM, severity of TR were classified into three grades according to the length of Doppler TR signal; mild (less than 2.5 cm), moderate (between 2.5 and 5.0 cm) and severe (more than 5.0 cm). In twenty-four of 37 normal subjects (64%), TR was detected but its degree of TR was mild. On the other hand, TR was observed in seventy of 72 patients with PM (97%) and forty-three of them (61%) showed moderate or severe TR. Peak velocity and pressure gradients in moderate or severe TR patients were significantly greater than those in patients with mild TR and normal controls. The follow-up period after implantation of PM was also significantly longer in moderate or severe TR than in mild TR. TR was significantly greater in patients with atrial fibrillation than in those with sinus rhythm. There were, however, no significant difference in the grade of TR between atrioventricular block and sick sinus syndrome. In addition, five of 8 patients with severe TR showed symptoms and signs of right-sided heart failure.
In conclusion, TR was common in patients with PM and the major cause of TR was related to the implanted pacing lead and the duration of PM implantation. And Doppler CFM is a sensitive method to detect and evaluate TR in patients with PM.