English
TitlePeak Systolic Pressure-volume Relationships in Man : Noninvasive Determination by Equilibrium Gated Radionuclide Angiocardiography and Cuff Sphygmomanometry
SubtitleOriginal Articles
AuthorsHaruhiko ADACHI*, Hiroki SUGIHARA*, Hiroaki NAKAGAWA*, Hiroshi KATSUME*, Masakazu OCHIAI*, Hamao IJICHI*
Authors(kana)
Organization*The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume22
Number2
Page157-168
Year/Month1985/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Abstract] We determined the relationship between left ventricular (LV) peak systolic pressure (PSP) and end-systolic volume, non-invasively using cuff sphygmomanometry and radionuclide angiocardiography (RNA) . Systolic blood pressure (SBP) measured in the arm was substituted for PSP. LV enddiastolic volume (EDV) , end-systolic volume (ESV) and ejection fraction (EF) were determined by a non-geometric method of gated RNA and recorded in three different hemodynamic states : at rest (basalstate) , during increased SBP after angiotensin administration (initial dose, 1-2μg/min) and during decreased SBP after nitrate (sublingual nitroglycerin, 0.3-0.6mg, or intravenous isosorbide dinitrate, 0.5-1.0mg/min) . The reproducibility of this method, tested in six subjects, proved to be good. Fifty-five subjects were divided into four groups based on EF at rest. The EDV and ESV were increased by angiotensin, and decreased by nitrate in all groups. EF was decreased by angiotensin and increased by nitrate. In contrast, the changes in PSP/ESVI due to these drugs remained in a narrow range in all groups. The regression lines of the PSP/ESVI relationship were almost linear and were steeper in the group with higher EF. Emax, the slope of the lines, was 5.75+-3.48mmHg/ml/m2 in group 1 (EF>50%) , 3.16+-1.83mmHg/ml/m2 in group 2 (EF 49-40%) , 2.27+-0.86mmHg/ml/m2 in group 3 (EF 39-30%) and 0.59+-0.50mmHg/ml/m2 in group 4 (EF<29%) . There were good correlations between Emax and EDVI at rest (hyperbolic function) and between Emax and EF at rest (exponential function) . The theoretical volume at zero pressure (VoI) did not meet in a definite value and was not related to EF at rest. Thus, the left ventricular peak systolic pressure-end-systolic volume relationship can be assessed non-invasively from radionuclide angiocardiography, which can be widely used for the evaluation of ventricular contractility, even in patients with asynergic ventricular contraction for whom echocardiography is unsuitable in measuring ventricular volume.
PracticeClinical medicine
KeywordsRadionuclide angiocardiography, Peak systolic pressure, End-systolic volume, Pressure-volume relation, Emax
Japanese
Title平衡時心プールシンチグラフィーによる収縮期末圧と容積関係の非侵襲的測定
Subtitle原著
Authors足立晴彦, 杉原洋樹, 勝目紘, 落合正和, 伊地知浜夫
Authors(kana)
Organization京都府立医科大学第二内科
Journal核医学
Volume22
Number2
Page157-168
Year/Month1985/2
Article原著
Publisher日本核医学会
Abstract「要旨」収縮期末の圧 (PSP) ・容積 (ESV) 関係は収縮性を反映する新しい指標として注目されている. ESVを平衡時心プールシンチグラフィーで求め, PSPを上腕での収縮期血圧で代用して, この関係を非侵襲的に測定する方法を検討した. アンギオテンシンによる昇圧でEDV, ESVは増大, 駆出率 (EF) は低下し, 亜硝酸剤による降圧でEDV, ESDは減少, EFは増大したが, PSP/ESVの変動は僅少であった. PSP/ESV関係はほぼ直線に回帰可能で, この傾斜Emaxは心機能低下群で低値をとった. PSP/ESV, Emaxなどの指標は前・後負荷に影響の少ない指標であり, これらの測定に, 左室形態の影響の少ないRIによる本法は非侵襲的心機能評価法として有用と考えられた.
Practice臨床医学：一般
KeywordsRadionuclide angiocardiography, Peak systolic pressure, End-systolic volume, Pressure-volume relation, Emax

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