Influence of Pericardium on Pulmonary Venous Flow Dynamics in Chronic Cardiac Diseases : Comparison with the Findings in Experimental Dogs with Acute Myocardial Infarction

The influences of pericardium on pulomanary venous flow dynamics were studied in 18 patients with chronic various cardiac diseases during open heart surgeries using transesophageal Doppler echocardiography. Pulmonary venous flow velocity(PVF) , transmitral flow velocity(TMF) and left atrial dimension were measured before and after pericardiotomy. In experimental canines with acute myocardial infarction, I also measured pulmonary venous flow profile by Doppler flow probe, left atrial dimensions by ultrasonomicrometry, and left atrial and left ventricular pressures by micromanometers, and I examined the effect of pericardium on pulmonary venous flow dynamics. In both clinical and experimental studies, measurements from PVF were peak flow velocity in ventricular systole (S wave) , that in diastole (D wave) and atrial contraction wave (A wave) , and measurements from TMF were peak velocity in early filling (E wave) and that in late filling (A wave). In clinical study, PVF profile throughout a cardiac cycle did not significantly change by pericardiotomy, whereas in canines with acute myocardial infarction, peak velocity of A wave in PVF was increased and ratios of D/S and DI/SI were significantly decreased at the condition of pericardiotomy. These results suggested that in chronic cardiac diseases, the restraint effect of pericardium might be less than that in canines with acute myocardial infarction, and chronic cardiac hypertrophy or dilatation might be accompanied with increase in pericardial compliance.

心嚢

肺静脈血流速波形

経僧帽弁血流速波形

経食道心血管エコー・ドプラ法

慢性心疾患