木佐貫 彰¹, 黒岩 竜一¹, 山下 積徳¹, 尾辻 豊¹, 村山 隆¹, 松下 亮治¹, 豊永 浩一¹, 宮園 芳孝¹, 中尾 正一郎¹, 野元 域弘², 田中 弘允¹

Akira KISANUKI¹, Ryuichi KUROIWA¹, Tsuminori YAMASHITA¹, Yutaka OTSUJI¹, Takashi MURAYAMA¹, Ryoji MATSUSHITA¹, Kouichi TOYONAGA¹, Yoshitaka MIYAZONO¹, Shoichiro NAKAO¹, Kunihiro NOMOTO², Hiromitsu TANAKA¹

¹鹿児島大学第1内科, ²国立南九州中央病院循環器科

¹The First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, ²The Department of Cardiology, Minami-Kyushu-Chuou National Hospital

キーワード : Pulmonary venous flow, Mitral stenosis, Transesophageal Doppler echocardiography

To assess the effect of posture on the pulmonary venous flow velocity pattern, we examined pulmonary venous flow in the supine and sitting positions in 11 patients with mitral stenosis using transesophageal pulsed Doppler echocardiography. The peak pulmonary venous systolic forward flow (S₂ wave), diastolic forward flow (D wave) and early systolic retrograde flow (C wave) velocities, and the intervals from the R wave of the electrocardiogram to the peaks of the S₂ wave (R-S interval) and D wave (R-D interval) were measured. The velocity of the S₂ wave was significantly decreased, from 38±9 to 32±10 cm/sec, after a change of posture from the supine to the sitting position. No significant changes were observed in the D wave (43±10 vs. 41±9 cm/sec), C wave (21±5 vs. 19±2 cm/sec), R-S interval (250±50 vs. 260±70 msec) or R-D interval (470±50 vs. 450±70 msec) upon postural changes. In conclusion, pulmonary venous flow velocity change due to a postural change seems to be different between systole and diastole. Pulmonary venous systolic flow velocity may be decreased upon a postural change from the supine to the sitting position in patients with mitral stenosis.