左心室重建的近期和远期疗效[英]／Mickleborough LL…／／J Thorac Cardiovasc Surg

通过再血管化进行心室重建是外科治疗冠心病伴左心室功能低下的有效方法。但在患者及最佳手术方式的选择等方面还存有争议。该研究报道了285例心壁薄弱导致心肌运动功能丧失或运动功能障碍的患者接受心室重建治疗后的疗效。     

甲状腺功能亢进症及减退症的左心室功能研究

作者应用心阻抗血流图法测定47例甲状腺功能异常患者的左心室功能情况,结果示,甲亢患者左心室心肌收缩力增强,甲退患者则反之,提示:可通过调节血中甲状腺激素水平来改善左心室心肌收缩功能。     

高血压伴与不伴糖尿病的患者左心室结构及功能的对比功能

高血压与糖尿病同时存在可使心血管病危险因素明显增加，糖尿病引起的代谢紊乱可加重左心室结构及功能的损害，本研究显示高血压伴糖尿病组左心室肥厚发生率更高，程度更重，左心室功能受损更明显，并且与血糖升高程度有关，提示改善非血液动力学因素与降压治疗具有同样重要的意义。     

平衡法核素心室造影检测老年冠心病左心室舒张早期功能的意义

应用平衡法核素心室造影测定４７例冠心病患者的左心室舒张功能（其中非心肌梗塞组３０例，陈旧性心肌梗塞组１７例）．结果发现，冠心病患者左心室舒张功能指标比收缩功能指标敏感，在舒张期功能指标中以反映左心室快速充盈的参数高峰充盈率（ＰＦＲ）最敏感，证明左心室舒张功能降低主要是舒张早期充盈障碍。     

左心室压力容积环

左心室与体循环动脉之间的相互作用是评价心血管功能的关键指标。本文简要回顾心室-动脉相互作用和耦合的部分评估方法，重点在于说明基本的生理原理和各种参数，包括侵入性与非侵入性方法。     

左心室假腱索的再认识

左心室假腱索(LVFT)是左心室心腔内一种常见的解剖变异，为连接室间隔与乳头肌或左心室游离壁的一种条索状结构，其形态和分布多样。LVFT并非是不发挥作用的“旁观者”:在电学方面，LVFT的附着部位是室性心律失常的潜在异位激动点；在力学方面，LVFT的牵拉与心室重塑密切相关；此外，LVFT也可能对血流动力学产生不良影响。现对LVFT的研究现状进行阐述。     

主动脉瓣置换术后显著肥大左心室的逆转

目的 :探讨主动脉瓣置换术后显著肥大左心室的逆转和收缩功能的恢复趋势及其影响因素。方法 :分析 1991年 1月至 2 0 0 0年 12月间 3 2例左心室显著肥大患者施行主动脉瓣置换术后超声心动图随访资料。结果 :主动脉瓣置换术后左心室形态呈进行性缩小、心肌肥厚显著减轻。影响显著肥大左心室术后完全逆转的主要术前因素是左心室的收缩末内径≥ 6 0cm、舒张末容积指数≥ 2 10ml/m2 和重量指数≥ 15 0g/m2 (P <0 0 1)。术前射血分数≥ 0 40者术后射血分数和短轴内径缩短率的恢复显著优于术前射血分数 <0 40者 (P <0 0 5～ 0 0 1)。术后射血分数≥ 0 5 0或短轴内径缩短率≥ 2 5 %与术后恢复时间呈正相关 ,与术前左心室收缩末内径≥ 6 0cm呈负相关 (R2 =0 5 5 ,P <0 0 1)。　　结论 :在左心室的收缩末内径≥ 6 0cm或舒张末容积指数≥ 2 10ml/m2 、重量指数≥ 15 0 g/m2 和射血分数 <0 40前手术 ,有利于术后左心室逆转和左心室收缩功能恢复 ,术后 6个月～ 1年是恢复的关键期。     

急性缺氧左心室舒张功能障碍家兔模型的实验研究

目的通过观察全身缺氧引起左心室舒张功能障碍时心肌组织三磷酸腺苷(ATP)和磷酸肌酸(CrP)的变化,探讨心室舒张功能障碍的发生机制.方法建立急性缺氧左心室舒张功能障碍动物(家免)模型,用高效液相法测定家免心肌组织中ATP和CrP的浓度.结果缺氧40min时家免左心室压力最大下降速率(-Lvdp/dtmax)绝对值显著下降(P＜0.05),左心室压力下降时间常数(T值)显著延长(P＜0.05).舒张功能障碍组ATP和CrP浓度显著低于对照组(P＜0.05).结论缺氧引起的心肌ATP和CrP含量减小,可能是急性缺氧左心室舒张功能障碍的原因之一.     

应用PTCA导引钢丝指引左心室电极导线的植入

双心室同步起搏已被充分证明可有效地改善充血性心力衰竭伴心室内传导阻滞患者的心功能[1,2 ] 。进行双心室同步起搏的一个技术关键是植入左心室起搏电极导线。目前可行并广泛应用的方法是经冠状静脉窦途径将电极导线插入心脏静脉起搏左心室 ,由于进入冠状静脉窦的心脏静脉较细、弯曲度大以及变异较多 ,直接用目前临床应用的冠状静脉窦电极导线插管难度大 ,X线照射时间长 ,且成功率受到影响。近来 ,一种新设计的带侧孔的 ,可用PTCA导引钢丝指引下插入的冠状静脉窦电极导线开始在临床应用。资料和方法2 2例充血性心力衰竭伴心室内阻滞患者 …     

钙通道阻滞剂治疗左心室肥厚

左心室肥厚是心肌组织的肥厚,是心脏对长期动脉高压适应的结果。本文叙述了左心室肥厚的病理生理异常情况。阐明口服钙通道阻滞剂可降低血压和减轻左心室肥厚,并能改善左心室充盈功能,室性心律失常,心肌缺血和左心室收缩的功能。表明钙通道阻滞剂为治疗本病的有效药物。     

Iatrogenic left pulmonary artery to left atrium fistula

Trans‐catheter balloon angioplasty is a well‐established treatment modality for pulmonary artery (PA) stenosis in children with congenital heart disease. We report a case of an unusual complication where a fistula developed between the left PA and the left atrium during balloon angioplasty in a patient with history of tetralogy of Fallot. This was successfully treated with placement of a covered stent. © 2014 Wiley Periodicals, Inc.     

Relationship of left atrial appendage function to left ventricular function

BACKGROUND: The study was conducted to evaluate the relationship of left atrial appendage function to left ventricular function and to analyze, if left ventricular dysfunction predisposed to left atrial appendage thrombus formation even in the presence of sinus rhythm. METHODS AND RESULTS: The study was conducted in 78 patients with a mean age of 53+/-8.5 years, all of whom were in sinus rhythm. Transesophageal echocardiography was performed to record the left atrial appendage emptying and filling velocity and to look for the presence of spontaneous echo contrast and thrombus. Patients with severe left ventricular dysfunction (Group I--left ventricular ejection fraction < 35%) and patients with moderate left ventricular dysfunction (Group II--left ventricular ejection fraction 35-45%) had lower left atrial appendage emptying velocity (33.6+/-16 and 39.7+/-19.5 cm/s, respectively) and filling velocity (41+/-14.7 and 41+/-17 cm/s, respectively) when compared to patients with preserved systolic function (Group II--left ventricular ejection fraction >45%), who had emptying and filling velocity of 55+/-16 and 56+/-15 cm/s, respectively (p <0.05). Twelve out of 32 (38%) patients with severe left ventricular dysfunction (Group I) and 7 out of 25 (28%) patients with moderate left ventricular dysfunction (Group II) had presence of left atrial appendage thrombus as compared to none of the patients with preserved left ventricular ejection fraction (Group III) (p <0.001). CONCLUSIONS: Patients with left ventricular dysfunction also had left atrial appendage dysfunction as evidenced by lower emptying and filling velocities and had increased incidence of thrombus formation.     

Submitral left ventricular aneurysm compressing the left main coronary artery

This report describes a 43-yr-old black woman who was referred for evaluation of severe mitral regurgitation. Conventional echocardiography revealed a large submitral left ventricular aneurysm. A selective coronary angiography demonstrated compression of the left main coronary artery by submitral aneurysm. Successful surgical repair was performed. Cathet. Cardiovasc. Diagn. 40:173–175, 1997. © 1997 Wiley-Liss, Inc.     

Double-outlet left ventricle

Two cases of double-outlet left ventricle with ventricular septal defects and pulmonic stenosis are described. Both had atrial situs solitus, one with concordant and another with discordant atrioventricular connections. Considering the clinical behaviour of the malformation, the diagnosis is difficult. Although the echocardiographic findings suggest the abnormality, angiocardiography is the best procedure for the accurate diagnosis.