小川 聡, 大木 崇, 井内 新, 河野 智彦, 内田 知行, 林 真見子, 青山 好美, 細井 憲三, 恵美 滋文, 福田 信夫, 森 博愛

Satoru OGAWA, Takashi OKI, Arata IUCHI, Tomohiko KAWANO, Tomoyuki UCHIDA, Mamiko HAYASHI, Yoshimi AOYAMA, Kenzo HOSOI, Sigefumi EMI, Nobuo FUKUDA, Hiroyoshi MORI

徳島大学医学部第二内科

The Second Department of Internal Medicine, Faculty of Medicine, University of Tokushima

キーワード : Venous flow, Pulmonary vein, Superior vena cava, Hypertrophic cardiomyopathy

To evaluate the diastolic properties of the right and left hearts, the left ventricular inflow velocity pattern (LVIF), the right ventricular inflow velocity pattern (RVIF) and the flow velocity pattern in the superior vena cava (SVCF) using transthoracic pulsed Doppler echocardiography, and the pulmonary venous flow pattern (PVF) using transesophageal pulsed Doppler echocardiography were analyzed in 33 patients with hypertrophic cardiomyopathy (HCM) and 12 normal control (N) subjects.
Our results were as follows:
1) In HCM, the peak velocity (PVD) of a diastolic wave and the ratio (PV-D/S) of the peak velocity of the diastolic wave to a second systolic wave of PVF were significantly decreased compared with the N subjects.
2) There were no significant differences in the mitral annulus motion and the peak velocity of the second systolic wave (PVS2) of PVF between the HCM and N groups.
3) PV-D/S of HCM was well correlated with the deceleration time (DT) and the deceleration rate (DcR) of the diastolic rapid filling wave of LVIF (r=-0.55, p4) The ratio (A/D) of the peak velocity of an atrial contraction wave to a diastolic rapid filling wave and the DcR of RVIF were significantly higher and lower in the HCM group than in the N subjects, respectively. The DcR of RVIF in the HCM group was fairly well correlated with interventricular septal wall thickness (r=0.42, p5) The DcR of RVIF in the HCM group with hypertrophy of the anterior right ventricular wall (RVH) was significantly lower than that of the HCM group without RVH. However, there were no significant differences in the parameters from SVCF between the HCM and N groups.
These findings suggest that PVF accurately reflects the mode of left ventricular diastolic dysfunction, but that the relationship between SVCF and RVIF was not as close as that between PVF and LVIF concerning ventricular diastolic function.