佐々木 徹, 松崎 益徳, 阿武 義人, 塔間 陽一, 弘山 直滋, 内田 孝子, 高橋 陽二郎, 内藤 秀敏, 民谷 正彰, 米沢 文雄, 楠川 禮造

Toru SASAKI, Masunori MATSUZAKI, Yoshito ANNO, Yoichi TOMA, Naoshige HIROYAMA, Takako UCHIDA, Yojiro TAKAHASHI, Hidetoshi NAITO, Masaaki TAMITANI, Fumio YONEZAWA, Reizo KUSUKAWA

山口大学医学部第二内科

The 2nd Department of Internal Medicine, Yamaguchi University School of Medicine

キーワード : mitral stenosis, mitral regurgitation, right atrium, left atrium, interatrial septum, esophageal echocardiography

　Esophageal echocardiographic analyses were performed in 7 cases with mitral stenosis of sinus rhythm and in 4 cases with mitral regurgitation of sinus rhythm to study the dynamics of both atria.
　In cases of mild mitral stenosis, characteristic findings were as follows: 1) increased atrial systolic excursion of the RA anterior wall and augmented atrial systolic fractional shortening of RA. 2) decreased interatrial septal motion with deflection in accordance with mitral opening snap. 3) enlargement of LA.
　However, in a case with severely compressed RA by LA RA anterior wall showed reduced atrial systolic excursion.
　In cases of mitral regurgitation, characteristic findings were as follows: 1) Systolic murmur at apex coincided with the shift of interatrial septum. 2) in one case, systolic fluttering of interatrial septum were recognized. 3) LA dilatation was found in 3 cases except for mitral valve prolapse syndrome. 4) Although total amplitude of IAS slightly larger than controls in 3 cases, atrial contraction wave amplitude was not large. 5) The passive emptying rate of IAS was slightly slower than controls, but II_A-onset of passive emptying interval was not different from controls.
　Esophageal echocardiography was very useful in observing the both atrial motion with various merits.