李 正明¹, 永野 玲子², 増山 理², 成山 和功¹, 大荒 貞男¹, 杉原 逸朗¹, 高橋 宏¹, 中村 幸二¹

Jung-Myung LEE¹, Reiko NAGANO², Tohru MASUYAMA², Kazunori NARIYAMA¹, Sadao OOARA¹, Itsurou SUGIHARA¹, Hiroshi TAKAHASHI¹, Kouji NAKAMURA¹

¹市立貝塚病院内科, ²大阪大学医学部第1内科

¹Department of Internal Medicine, Kaizuka Municipal Hospital, ²The First Department of Medicine, Osaka University School of Medicine

キーワード : Hypertension, Pulsed Doppler, Pulmonary venous flow velocity

Although the Doppler mitral flow velocity pattern changes in accordance with the degree of left ventricular diastolic dysfunction, it is "normalized" in the presence of heart failure. In this study the pulmonary venous flow velocity pattern was characterized in 60 hypertensive patients with and without heart failure to clarify whether analysis of the pulmonary venous flow velocity pattern provides complementary information in the interpretation of the mitral flow velocity pattern. The mitral flow velocity pattern in 42 hypertensive patients without heart failure was characterized by decreases in the peak early diastolic filling velocity (E) and increases in the ratio of peak filling velocity at atrial contraction to E. The mitral flow velocity pattern was "normalized" in 18 patients with heart failure, without any differences in the indexes of the mitral flow velocity pattern as compared to 24 normals. The pulmonary venous flow velocity pattern in hypertensive patients without heart failure was characterized by decreases in the peak diastolic forward flow velocity (D) and increases in the ratio of peak systolic forward flow velocity (S) to D(S/D ratio). In patients with heart failure, D was higher and the S/D ratio was lower compared to hypertensive patients without heart failure (pConclusions: The pulmonary venous flow velocity pattern in hypertensive patients without heart failure was characterized by decreases in D and increases in the S/D ratio. The characteristic abnormal pattern was "supernormalized" in association with heart failure. Thus, pulmonary venous flow velocity patterns appeared to be more reliable than mitral flow velocity patterns in differentiating subgroups of hypertensive patients. Analysis of pulmonary venous flow velocity patterns in conjunction with mitral flow velocity patterns provides a useful information in the interpretation of mitral flow velocity patterns in hypertensive patients with and without heart failure.