Japanese
Title健常者の左室拡張早期充満の加齢による変化と左室局所の不調和充満の関与について
Subtitle原著
Authors古谷雄司*, 矢野雅文**, 油木賢一**, 山田裕篤**, 山岸隆*, 尾崎正治*, 楠川禮造*
Authors(kana)
Organization*山口大学医学部第二内科, **国立浜田病院
Journal核医学
Volume27
Number3
Page199-208
Year/Month1990/3
Article原著
Publisher日本核医学会
Abstract「要旨」 健常者の左室拡張早期充満の加齢による変化と左室局所の不調和充満の関与を検討するため, 健常者48名 (15〜73歳) を対象に, 安静時心プール検査を行った. 左室を拡張末期像の面積重心を中心に4分割し, 中隔部, 心尖部および側壁部につきTime-activity curveとその一次微分曲線を作成し, Peak filling rate (PFR) と左室全体の収縮末期より各局所のPFRまでの時間 (Time to peak filling rate (TPFR) ) の年齢による変化について, 左室全体および各局所につき検討した. 加齢により左室全体のPFRは低下し, 局所のTPFRの差が大きいほど, 左室全体のPFRは低下した. 局所のTPFRの加齢による変化には差があり, 心尖部, 中隔部では, 加齢とともにTPFRは増加するが, 側壁部では年齢によらず一定であった. 以上より, 加齢により側壁部と心尖部, 中隔部の間の拡張早期充満の生理的不協調性 (Physiologic asynchrony) が増加し, それが左室全体のPFRの低下の一因となっているものと考えられた.
Practice臨床医学：一般
KeywordsAging, Systolic and diastolic function, Physiologic asynchrony
English
TitleAge-Related Modification of Regional Left Ventricular Filling in Normal Subjects
SubtitleOriginal Articles
AuthorsYuhji FURUTANI*, Masafumi YANO**, Kenichi YUKI**, Hiroatsu YAMADA**, Takashi YAMAGISHI*, Masaharu OZAKI*, Reizo KUSUKAWA*
Authors(kana)
Organization*Second Department of Internal Medicine, Yamaguchi University School of Medicine, **National Hamada Hospital
JournalThe Japanese Journal of nuclear medicine
Volume27
Number3
Page199-208
Year/Month1990/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Age-related reduction in global left ventricular filling has been reported. To assess how regional left ventricular filling is modified by aging, radionuclide ventriculography was conducted in 48 normal subjects aged 15 to 73 years. Left ventricular regional filling was assessed by dividing left ventricular region of interest into 4 quadrants, from which global (GLB) , septal (SEP) , apical (Ax) and lateral (LAT) time-activity curves and first-derivative curves were derived. Indexes of left ventricular systolic function at rest did not vary with age, but early diastolic filling significantly declined with age : peak filling rate normalized to end-diastolic volume (EDV/S) , peak filling rate normalized to stroke volume (SV/s) and peak filling rate/peak ejection rate decreased (r=-0.42 ; p<0.01, r=-0.48 ; p<0.001, r=-0.47 ; p<0.001) , time to peak filling rate increased (r=0.41 ; p<0.01) with aging. Early diastolic asynchrony was measured as the sum of the absolute values of the time differences from global peak filling rate to that in each of three quadrants (ΔTPFR) . ΔTPFR increased with age (r=0.37 ; p<0.01) . Moreover, ΔTPFR correlated with global peak filling rate (EDV/s) , peak filling rate (SV/s) and peak filling rate/peak ejection rate (r=-0.40 ; p<0.01, r=-0.45 ; p<0.01, r=-0.51 ; p<0.001) . Time to peak filling rate of the lateral region was the shortest (163+-38ms) , followed by the global (179+-36ms) , apical (184+-38ms) and finally the septal region (195+-35ms) . This suggested that physiologic asynchrony with regard to the sequence of regional filling exists in resting condition in normal subjects. Time to peak filling rate in the septal and apical regions increased with age (r=0.29 ; p<0.05, r=0.30 ; P<0.05) , but that in the lateral region did not correlate with age (r=0.11) . These regional differences correlated with increase in ΔTPFR. Thus, aging alter left ventricular diastolic function, with reduced rate related to increased asynchronous early diastolic filling due to prolongation of time to peak filling rate in the septal and apical regions.
PracticeClinical medicine
KeywordsAging, Systolic and diastolic function, Physiologic asynchrony

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