浅井 崇史¹, 岩瀬 正嗣², 杉本 邦彦³, 犬塚 斉³, 中野 由紀子³, 梶原 克祐³, 鈴木 仁⁴, 山田 晶⁴, 松山 裕宇⁴, 菱田 仁⁴

Takashi ASAI¹, Masatsugu IWASE², Kunihiko SUGIMOTO³, Hitoshi INUDUKA³, Yukiko NAKANO³, Katsusuke KAZIWARA³, Megumi SUZUKI⁴, Akira YAMADA⁴, Hiroyuki MATSUYAMA⁴, Hitoshi HISHIDA⁴

¹藤田保健衛生大学衛生学部衛生技術科, ²藤田保健衛生大学短期大学医療情報技術学科, ³藤田保健衛生大学病院臨床検査部, ⁴藤田保健衛生大学病院循環器内科

¹Fujita Health University, School of Health Science, Faculty of Medical Technology, ²Department of Medical Information Technology in Junior College, Fujita Health University, ³Department of Clinical laboratory, Fujita Health University School of Medicine, ⁴Department of Internal Medicine, Fujita Health University School of Medicine

キーワード : left atrial volume, cubic equation, ellipsoidal formula, biplane modified Simpson rule, three-dimensional echocardiography

目的：健常者における左房容積の妥当な計測法および正常値を再評価すること. 対象および方法：健常成人男性100 人(平均25.1±3.6 歳) を対象とし, Cube (C) 法, Ellipsoid (E) 法, Biplane Simpson (bp) 法を用いて左房容積を計測して比較するとともに, 従来の報告とも比較した. このうち22 例では3D 法とも比較した. 結果：C 法16.1±5.0 ml, E法26.3±7.2 ml, bp 法37.9±10.4 ml でありbp 法は他の2 法より有意に大であった. bp 法と3D 法で計測した22 例ではそれぞれ, 37.0±11.0 ml, 37.5±11.1４ ml であり両者に有意差はなかった. 体表面積で補正したbp 法の左房容積係数(LAVI) は22±5 ml ⁄m2 であり, 最近よく引用されているWang の20±6 ml ⁄m2 と同様であった. 考察および結語： 左房容積計測はC 法やE 法の簡易式では健常人でも過小評価となり従来の報告同様にbp 法で計測すべきであり, 3D 法とも良好な一致が見られたことから信頼性も高く, 日常的に使用すべきと考えられた.

Purpose: To validate a reasonable left atrial volume (LAV) measurement in a normal population, multiple echocardiographic methods were used to evaluate normal reference values of LAV. Subjects and Methods: The study subjects consisted of 100 healthy young male adults. Ages ranged from 20 to 45 years (average 25.1賊3.6). LA size was measured with the 2 Danteroposterior linear dimension (APD); the cubic equation with APD (Cube method); the ellipsoidal formula (Ellipmethod); and Biplane modified Simpson rule (Biplane method). Three-dimensional echocardiography (3D) was also applied in 22 cases. Results and Discussion: The Cube (16.1賊5.0 ml) and Ellipsoid (26.3賊7.2 ml) methods significantly underestimated the LAV compared to the Biplane method (37.9賊10.4 ml). In 22 cases, no significant difference was observed between LAV derived by 3D method (37.5賊11.1 ml) and those derived by the Biplane method (37.0賊11.0 ml). The mean LA volume index (for body surface area) was 22賊5, similar to recently quoted values (22賊6) reported by Wang et al. Conclusion: LA single or triple linear dimensions derived assumptions were not accurate for LA volume measurements. The Biplane method has the closest agreement to 3D methods and is readily applicable with current echocardiographic equipment. The Biplane method should be routinely applied in clinical practice as already reported.