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タイトル食道内断層心エコー・ドプラー法による左心房・左心耳内血栓の検出と左心耳内血流動態について
タイトルヨミショクドウナイ ダンソウ シンエコー ドプラーホウ ニ ヨル サシンボウ サシンジナイ ケッセン ノ ケンシュツ ト サシンジナイ ケツリュウ ドウタイ ニ ツイテ
タイトル別表記Detection of Mural Thrombi and the Analysis of Blood Flow Velocity in the Left Atrial Appendage by Transesophageal 2-D Echocardiography Combined with Pulsed Doppler Flowmeter
作成者末次, 正治
作成者ヨミスエツグ, マサハル
作成者別表記Suetsugu, Masaharu
作成者所属山口大学医学部
内容記述(抄録等)To examine the relation of the blood flow velocity and thrombogenesis in the left atrium (LA) and the left atrial appendage (LAA), we performed transesophageal two-dimensional echocardiography (Eso 2-D Echo) combined with pulsed Doppler flowmeter, which was developed in our laboratory. Forty-three patients (pts) were included in this study ; 15 pts with sinus rhythm including 4 mitral stenosis (MS) and 11 normal subjects and the remaining 28 pts with atrial fibrillation (Af). The pts with Af were classified into 3 groups ; Af-I : Af without MS and cerebral infarction (CI), Af-II : Af with CI, Af-III : Af with MS. In four of 10 pts with MS and Af (Af-III), mural thrombi were detected in LA or LAA by Eso 2-D Echo, but those were not visualized by conventional echocardiography, and in two of 9 pts with Af and CI (Af-II), abnormal string echo in LAA was observed by Eso 2-D Echo. Thus, Eso 2-D Echo seemed to be superior to the conventional 2-D echocardiography to detect abnormal structure in LA orLAA. In sinus rhythm, biphasic flow pattern following the P wave on ECG, was seen in the vicinity of the junction between LA and LAA, while in Af the flow of saw-tooth appearance was observed throughout a cardiac cycle. The peak flow velocity in LAA was significantly decreased in Af than that of sinus rhythm (p<0.05). Especially in Af with MS (Af-III), the peak flow velocity was markedly decreased (1±4cm/sec : mean±SD) compared with Af without MS (Af-I and II, p<0.01). In Af with CI (Af-II), the peak flow velocity in LAA was significantly lower (11±4cm/sec) than pts without CI (Af-I : 21±9cm/sec, p<0.05), and blood stagnation in LAA was strongly suggested in Af-II. These results indicated that the analysis of the blood flow velocity in LAA by Eso 2-D Echo is of great value in assessment of thrombogenesis in LAA, and pts with Af even without MS, who has markedly reduced peak flow velocity in LAA, should be prophylactically anticoagulated.
本文言語jpn
主題医学
資料タイプtext
出版者山口大学医学会
出版者ヨミヤマグチ ダイガク イガッカイ
NII資料タイプ学術雑誌論文
査読の有無査読あり
ISSN0513-1731
NCIDAN00243156
学内刊行物(紀要等)山口医学
掲載誌名山口医学
35
6
開始ページ343
終了ページ351
発行日1986-12
著者版/出版社版その他
リポジトリIDB030035000604
地域区分山口大学
URIhttp://www.lib.yamaguchi-u.ac.jp/yunoca/handle/B030035000604