| Japanese |
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| Title | Cold Pressor Testによる健常人および高血圧患者における左室拡張機能動態の検討 |
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| Subtitle | 原著 |
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| Authors | 立川弘孝*, 杉原洋樹*, 古川啓三*, 足立晴彦*, 勝目紘*, 中川雅夫*, 岡嶋泰**, 嶺尾徹**, 宮尾賢爾**, 小関忠尚**, 小寺秀幸***, 村田稔*** |
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| Authors(kana) | |
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| Organization | *京都府立医科大学第二内科, **京都第二赤十字病院内科, ***放射線科 |
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| Journal | 核医学 |
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| Volume | 25 |
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| Number | 5 |
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| Page | 405-412 |
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| Year/Month | 1988/5 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」末梢血管抵抗の増大をもたらす寒冷昇圧試験 (CPT) により, 急性後負荷増大に対する左室収縮および左室拡張機能の変化を健常者 (N群) 10名とWHO I〜II期の高血圧症患者 (HT群) 10名を対象に比較検討した. 負荷前後で, リストモード心プールシンチグラフィにより, 心電図R波順方向性および逆方向性左室容量曲線を作成し, 前者より収縮期指標として駆出率 (EF) , その一次微分曲線より拡張早期指標としての最大充満速度 (PFR) , および後者から左房収縮寄与率 (AC/SV) について検討した. CPTにより, 両群とも心拍数は不変, 血圧は上昇し, HT群での血圧上昇は大なる傾向を示した. 収縮期指標であるEFは負荷前には2群間で有意差を認めず, CPTによりN群, HT群とも低下し, CPT負荷後も2群間に有意差はなかった. 拡張早期指標であるPFRは, 負荷前HT群はN群より低く, CPTにより両群とも低下した. 左室充満に対するAC/SVは, 負荷前HT群はN群より高値を示し, CPTにより両群とも増加したが, HT群での増大はより高度であった. 以上より, 健常者では急性の後負荷増大により, 拡張早期流入障害が起こり, それを代償するように左房収縮の関与が増大したが, WHO I〜II期の比較的臓器障害の少ないと考えられる高血圧症患者においては, 負荷前より存在した拡張早期流入障害はさらに障害され, 心房収縮期左室充満量も高度に増大した. |
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| Practice | 臨床医学：一般 |
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| Keywords | Radionuclide ventriculography, Cold pressor test, Hypertension, Diastolic function. |
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| English |
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| Title | Assessment of Left Ventricular Diastolic Function during Cold Pressor Test (CPT) in Normal Subjects and Patients with Hypertension |
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| Subtitle | Original Articles |
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| Authors | Hirotaka TATSUKAWA*, Hiroki SUGIHARA*, Yasushi OKAJIMA**, Keizo FURUKAWA*, Haruhiko ADACHI*, Tooru MINEO**, Hiroshi KATSUME*, Kenji MIYAO**, Tadanao OZEKI**, Masao NAKAGAWA*, Hideyuki KODERA***, Minoru MURATA*** |
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| Authors(kana) | |
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| Organization | *The Second Department of Internal Medicine, Kyoto Prefectural University of Medicine, **Department of Internal Medicine, ***Department of Radiology, Kyoto Second Red Cross Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 25 |
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| Number | 5 |
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| Page | 405-412 |
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| Year/Month | 1988/5 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] To evaluate left ventricular (LV) diastolic function to cold pressor test (CPT) , radionuclide ventriculography was performed in 10 patients with hypertension (HT) and in 10 normal subjects (N) . The data were acquired in a list mode R wave as a time marker and multigated images were reformatted forward and backward the time marker. Ejection fraction (EF) as a systolic index and peak filling rate (PFR) , as an index of early diastolic phase, were calculated from the forward gating left ventricular volume curve and its first differential curve. And atrial contractile fraction to the ventricular filling (AC/SV) was calculated from the backward left ventricular volume curve. Heart rate was not significantly changed by CPT in both groups. During CPT mean blood pressure increased in HT higher than in N. EF decreased (N: 59.7+-3% to 57.4+-4%; p<0.025, HT: 60.3+-6% to 56.0+-7%; P<0.01) . PFR at rest was lower in HT group than in N group, and decreased during CM in both groups (N: 4.9+-0.7 SV/sec to 4.5+-0.7 SV/sec; P<0.005, HT: 3.9+-0.7 SV/sec to 3.6+-1.O SV/sec; P<0.05) . In contrast, AC/SV increased significantly (N: 15.5+-4.7% to 18.4+-7.1%; p<0.025, HT: 24.9+-6.0% to 30.5+-9.0%; p<0.005) . These results suggest that pre-existing early diastolic LV dysfunction in HT patients is further deteriorated with acute increase in afterload by CPT, and that this early diastolic impairment is compensated by atrial contraction. |
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| Practice | Clinical medicine |
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| Keywords | Radionuclide ventriculography, Cold pressor test, Hypertension, Diastolic function. |
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