目的观察国产C-L短柱侧倾碟瓣主动脉瓣置换术后中期血流动力学的表现,并评价其功能。方法选择20例单纯主动脉瓣置换术后>5年的患者分为2组,C-L短柱侧倾碟瓣组:采用C-L短柱侧倾碟瓣(21mm)行主动脉瓣置换术;M edtron ic-H a ll组:采用M...目的观察国产C-L短柱侧倾碟瓣主动脉瓣置换术后中期血流动力学的表现,并评价其功能。方法选择20例单纯主动脉瓣置换术后>5年的患者分为2组,C-L短柱侧倾碟瓣组:采用C-L短柱侧倾碟瓣(21mm)行主动脉瓣置换术;M edtron ic-H a ll组:采用M edtron ic-H a ll侧倾碟瓣(21mm)行主动脉瓣置换术,每组10例。比较两组静息状态下的最大跨瓣压差(ΔP)、平均跨瓣压差(ΔPm)和瓣膜有效开口面积(EOA)。结果在静息状态下,C-L短柱侧倾碟瓣组和M edtron ic-H a ll组的ΔP分别为11.63±3.23mmHg(1kPa=7.5mmHg)和9.78±3.35mmHg,ΔPm分别为6.25±2.32mmHg和5.85±2.32mmHg,EOA分别为1.07±0.17cm2和1.25±0.27 cm2,两组比较差异无统计学意义(P>0.05)。结论主动脉瓣置换术后中期血流动力学检测结果显示,C-L短柱侧倾碟瓣与M edtron ic-H a ll侧倾碟瓣的血流动力学结果相似,其功能良好,是一个可靠的心脏瓣膜。展开更多
Objective: Ventricular filling takes place during the conduit and pump functio ns of the atrium. While studying whether relief of mitral valve obstruction impr oves atrial filling, the effect of age on atrial contribu...Objective: Ventricular filling takes place during the conduit and pump functio ns of the atrium. While studying whether relief of mitral valve obstruction impr oves atrial filling, the effect of age on atrial contribution to ventricular fil ling was studied before and after balloon mitral valvuloplasty (BMV) and on foll ow-up at 1 year. Methods: Patients with mitral stenosis (MS) and sinus rhythm ( n=59) were divided into group I (< 18 years, n=13), group II (< 30 years, n=29) and group III (>30 years, n=17). Two-dimensional mitral valve area (MVA in cm2) , transmitral mean gradient (MG in mm Hg), velocity time integral (VTI in cm) of mitral valve flow, VTI contributed by atrial systole (A-VTI), difference betwe en total VTI and A-VTI (E-VTI), percentage contribution of A-VTI to the total VTI (A-%) and difference between A-%before and after BMV (δ-A-%) were n oted. Follow-up data was obtained at 1 year. The change in A-%at follow-up ( A-%-FU) was calculated as the difference between A-%before BMV and A-%at follow-up. Results: There was a similar increase in MVA with a reduction in MG among the three groups. Among the three groups, total VTI and E-VTI before and after BMV were similar. Before BMV, in all the groups, A-VTI and A-%were simi lar. After BMV, there was increase in A-VTI and A-%in all the groups with a t rend to be more in younger patients. A-VTI was significantly higher in group I only. But E-VTI had decreased significantly in all groups and tended to be less in younger patients. In younger patients, δ-A-%after BMV was significantly higher (13.2±7.6, 7.9±5.1 and 6.5±4.5, respectively, in groups I, II and III; p< 0.01). Correlation coefficient of age against δ-A-%was -0.55 (p< 0.01). Correlation coefficients of δ-A-%against post-BMV-MVA and MG were not goo d. At follow-up of 11.3±1.2 months, changes achieved in total VTI, A-VTI, EVT I and A-%were maintained. Total VTI, A-VTI, E-VTI and A-%were similar at t he time of follow-up on comparing the three groups. But younger patients had si gnificantly higher A-%-FU (12.1±5.8, 9.4±4.6 and 7.3±3.1, respectively, in groups I, II and III; p< 0.01). Conclusions: Prior to BMV, there is an age rela ted reduction in atrial contribution to ventricular filling that improves with r elief of MS. Advancing age reduces the immediate and late recovery of atrial con tribution after BMV. This may be due to increasing left atrial fibrosis with age that prevents an improvement in atrial pump function. The differential improvem ent in atrial function in younger patients warrants earlier intervention in MS to achieve better recovery of atr ial function.展开更多
文摘目的观察国产C-L短柱侧倾碟瓣主动脉瓣置换术后中期血流动力学的表现,并评价其功能。方法选择20例单纯主动脉瓣置换术后>5年的患者分为2组,C-L短柱侧倾碟瓣组:采用C-L短柱侧倾碟瓣(21mm)行主动脉瓣置换术;M edtron ic-H a ll组:采用M edtron ic-H a ll侧倾碟瓣(21mm)行主动脉瓣置换术,每组10例。比较两组静息状态下的最大跨瓣压差(ΔP)、平均跨瓣压差(ΔPm)和瓣膜有效开口面积(EOA)。结果在静息状态下,C-L短柱侧倾碟瓣组和M edtron ic-H a ll组的ΔP分别为11.63±3.23mmHg(1kPa=7.5mmHg)和9.78±3.35mmHg,ΔPm分别为6.25±2.32mmHg和5.85±2.32mmHg,EOA分别为1.07±0.17cm2和1.25±0.27 cm2,两组比较差异无统计学意义(P>0.05)。结论主动脉瓣置换术后中期血流动力学检测结果显示,C-L短柱侧倾碟瓣与M edtron ic-H a ll侧倾碟瓣的血流动力学结果相似,其功能良好,是一个可靠的心脏瓣膜。
文摘Objective: Ventricular filling takes place during the conduit and pump functio ns of the atrium. While studying whether relief of mitral valve obstruction impr oves atrial filling, the effect of age on atrial contribution to ventricular fil ling was studied before and after balloon mitral valvuloplasty (BMV) and on foll ow-up at 1 year. Methods: Patients with mitral stenosis (MS) and sinus rhythm ( n=59) were divided into group I (< 18 years, n=13), group II (< 30 years, n=29) and group III (>30 years, n=17). Two-dimensional mitral valve area (MVA in cm2) , transmitral mean gradient (MG in mm Hg), velocity time integral (VTI in cm) of mitral valve flow, VTI contributed by atrial systole (A-VTI), difference betwe en total VTI and A-VTI (E-VTI), percentage contribution of A-VTI to the total VTI (A-%) and difference between A-%before and after BMV (δ-A-%) were n oted. Follow-up data was obtained at 1 year. The change in A-%at follow-up ( A-%-FU) was calculated as the difference between A-%before BMV and A-%at follow-up. Results: There was a similar increase in MVA with a reduction in MG among the three groups. Among the three groups, total VTI and E-VTI before and after BMV were similar. Before BMV, in all the groups, A-VTI and A-%were simi lar. After BMV, there was increase in A-VTI and A-%in all the groups with a t rend to be more in younger patients. A-VTI was significantly higher in group I only. But E-VTI had decreased significantly in all groups and tended to be less in younger patients. In younger patients, δ-A-%after BMV was significantly higher (13.2±7.6, 7.9±5.1 and 6.5±4.5, respectively, in groups I, II and III; p< 0.01). Correlation coefficient of age against δ-A-%was -0.55 (p< 0.01). Correlation coefficients of δ-A-%against post-BMV-MVA and MG were not goo d. At follow-up of 11.3±1.2 months, changes achieved in total VTI, A-VTI, EVT I and A-%were maintained. Total VTI, A-VTI, E-VTI and A-%were similar at t he time of follow-up on comparing the three groups. But younger patients had si gnificantly higher A-%-FU (12.1±5.8, 9.4±4.6 and 7.3±3.1, respectively, in groups I, II and III; p< 0.01). Conclusions: Prior to BMV, there is an age rela ted reduction in atrial contribution to ventricular filling that improves with r elief of MS. Advancing age reduces the immediate and late recovery of atrial con tribution after BMV. This may be due to increasing left atrial fibrosis with age that prevents an improvement in atrial pump function. The differential improvem ent in atrial function in younger patients warrants earlier intervention in MS to achieve better recovery of atr ial function.
