- 期刊
Analysis of Patients with Paradoxical Septal Motion
心室中隔反常運動病人之分析
摘要
Two hundred and forty-one patients with paradoxical septal motion were studied. Of the total, 27 patients had atrial septal defects (ASD), 61 patients had mitral stenosis (MS), 32 patients were those examined following cardiac surgery, and the remaining 121 patients had other diseases. Echocardiograms of patients with ASD were studied. Echocardiograms and hemodynamic data of patients with MS and patients following cardiac surgery were also studied. In patients with ASD, right ventricular end-diastolic dimension (RVIDd) and the ratio of RVIDd to left ventricular end-diastolic dimension (RVIDd/LVIDd ratio) were found to be greater in patients with paradoxical septal motion than in patients with normal septal motion (36.4±8.4 vs 24.8±13.1 mm, p＜0.01) and (1.08±0.28 vs 0.61±0.30, p＜0.001), respectively. LVIDd was smaller in the former than in the latter groups of patients (35.0±5.0 vs 42.4±4.8 mm, p＜0.001). RVIDd and RVIDd/LVIDd ratio were greater in patients with type A paradoxical septal motion than in patients with type B paradoxical septal motion. Values were 44.2±5.2 vs 34.6±8.0 mm (p＜0.05), and 1.40±0.12 vs 1.01±0.25 (p＜0.001), respectively. In patients with mitral stenosis, the E-F slope was smaller in those patients with early diastolic dip of the interventricular septum (IVS) than those without the dip (16.51±12.65 vs 21.72±15.36 mm/sec, p＜0.01). RVIDd/LVIDd ratio was greater in patients with early diastolic dip of IVS than in patients without it (0.402±0.224 vs 0.353±0.198, p＜0.05). Preoperative pulmonary artery wedge pressure (PAW), cardiac output (CO), right ventricular end-diastolic pressure (RVEDP), LVEDP, PA pressure (systolic and diastolic) were not significantly different in both groups of patients. We speculate that patients with early diastolic dip of IVS have more severe MS than patients without it. In patients undergoing heart surgery, preoperative echocardiographic RVIDd, LVIDd, RVIDd/LVIDd and ejection fraction (EF), preoperative PAW, LVEDP, LV systolic pressure, RVEDP, RV systolic pressure, PA pressure (systolic and diastolic), C 0, and total cardiopulmonary bypass time during operation were not significantly different in groups of patients with and without postoperative paradoxical septal motion. The cause for the development of postoperative paradoxical septal motion still needs further investigation.
關鍵字
無資料並列摘要
Two hundred and forty-one patients with paradoxical septal motion were studied. Of the total, 27 patients had atrial septal defects (ASD), 61 patients had mitral stenosis (MS), 32 patients were those examined following cardiac surgery, and the remaining 121 patients had other diseases. Echocardiograms of patients with ASD were studied. Echocardiograms and hemodynamic data of patients with MS and patients following cardiac surgery were also studied. In patients with ASD, right ventricular end-diastolic dimension (RVIDd) and the ratio of RVIDd to left ventricular end-diastolic dimension (RVIDd/LVIDd ratio) were found to be greater in patients with paradoxical septal motion than in patients with normal septal motion (36.4±8.4 vs 24.8±13.1 mm, p＜0.01) and (1.08±0.28 vs 0.61±0.30, p＜0.001), respectively. LVIDd was smaller in the former than in the latter groups of patients (35.0±5.0 vs 42.4±4.8 mm, p＜0.001). RVIDd and RVIDd/LVIDd ratio were greater in patients with type A paradoxical septal motion than in patients with type B paradoxical septal motion. Values were 44.2±5.2 vs 34.6±8.0 mm (p＜0.05), and 1.40±0.12 vs 1.01±0.25 (p＜0.001), respectively. In patients with mitral stenosis, the E-F slope was smaller in those patients with early diastolic dip of the interventricular septum (IVS) than those without the dip (16.51±12.65 vs 21.72±15.36 mm/sec, p＜0.01). RVIDd/LVIDd ratio was greater in patients with early diastolic dip of IVS than in patients without it (0.402±0.224 vs 0.353±0.198, p＜0.05). Preoperative pulmonary artery wedge pressure (PAW), cardiac output (CO), right ventricular end-diastolic pressure (RVEDP), LVEDP, PA pressure (systolic and diastolic) were not significantly different in both groups of patients. We speculate that patients with early diastolic dip of IVS have more severe MS than patients without it. In patients undergoing heart surgery, preoperative echocardiographic RVIDd, LVIDd, RVIDd/LVIDd and ejection fraction (EF), preoperative PAW, LVEDP, LV systolic pressure, RVEDP, RV systolic pressure, PA pressure (systolic and diastolic), C 0, and total cardiopulmonary bypass time during operation were not significantly different in groups of patients with and without postoperative paradoxical septal motion. The cause for the development of postoperative paradoxical septal motion still needs further investigation.