WEKO3
アイテム
超音波連続波ドプラー法による僧帽弁位および大動脈弁位置換弁の弁開放能の評価
https://doi.org/10.11501/3087614
https://doi.org/10.11501/3087614f773bcbf-81a7-4d50-8b45-5c0968721d95
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
000000248079.pdf (11.2 MB)
|
|
| Item type | 学位論文 / Thesis or Dissertation(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2015-06-04 | |||||
| タイトル | ||||||
| タイトル | 超音波連続波ドプラー法による僧帽弁位および大動脈弁位置換弁の弁開放能の評価 | |||||
| タイトル言語 | ja | |||||
| タイトル | ||||||
| タイトル | Continuous wave Doppler echocardiographic assessment of prosthetic valves in the mitral and aortic position | |||||
| タイトル言語 | en | |||||
| タイトル | ||||||
| タイトル | チョウオンパ レンゾクハ ドプラーホウ ニヨル ソウボウ ベンイ オヨビ ダイドウミャク ベンイ チカンベン ノ ベン カイホウノウ ノ ヒョウカ | |||||
| タイトル言語 | ja-Kana | |||||
| 著者 |
木佐貫, 彰
× 木佐貫, 彰 |
|||||
| 言語 | ||||||
| 言語 | jpn | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | continuous wave Doppler echocardiography | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | prosthetic mitral valve | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | prosthetic aortic valve | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_46ec | |||||
| 資源タイプ | thesis | |||||
| ID登録 | ||||||
| ID登録 | 10.11501/3087614 | |||||
| ID登録タイプ | JaLC | |||||
| 要約 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | Noninvasive evaluation of the prosthetic valve function remains a clinical challenge. Earlier noninvasive techniques were of limited success because of their inability to provide hemodynamic inforrnation. However, recently developed continuous wave Doppler echocardiography has enabled us to determine transvalvular pressure gradients. We evaluated the prosthetic valve opening function in the mitral and aortic position using continuous wave Doppler echocardiography. I: Prosthetic mitral valve. To evaluate the opening function of prosthetic valves in the mitral position, the mitral flow velocity pattern was recorded with continuous wave Doppler echocardiography in 55 patients with prosthetic mitral valves (34 patients with St. Jude Medical and 21 with porcine xenograft valves). Twenty patients with mitral stenosis and 15 normal subjects were served as controls. An ultrasonic transducer was placed over the left ventricular apex and the direction of the ultrasonic beam was positioned to be parallel with the mitral flow using the Doppler audio-signals. A pressure gradient was calculated form the peak flow velocity with a simplified Bernoulli equation. The peak flow velocity, the pressure half time and the peak and mean pressure gradients were measured to evaluate the opening function of the prosthetic valves. The results were as follows; 1. The values of the peak flow velocity, the pressure half time, the peak and mean pressure gradients in patients with St. Jude Medical valves (1.4±0.3 m/sec, 90±20 mesc, 7.9±2.8 mmHg and 3.5±1.1 mmHg, respectively) and in patients with porcine xenograft valves (1.6±0.3 m/sec, 130±40 msec, 11.2±4.0 mmHg and 4.8±2.1 mmHg, respectively) were significantly larger than those in normal subjects (0.8±0.1 m/sec, 70±10 msec, 2.8±0.8 mmHg and 1.2±0.4 mmHg, respectively) (P<0.01 or P<0.001), but significantly smaller than those in patients with mitral stenosis (1.9±0.3 m/sec, 240±70 msec, 14.6±4.6 mmHg and 8.2±3.8 mmHg, respectively) (P<0.02, P< 0.01 or P<0.001). All measurements of the 4 indices in patients with the St. Jude Medical valves were significantly smaller than those in patients with the porcine xenograft valves (P<0.01). 2. The changes in the 4 indices related to the valvular size were small in patients with St. Jude Medical and porcune xenograft valves. 3. The correlation between the peak flow velocity (Y_1), the peak pressure gradient (Y_2) and the mean pressure gradient (Y_3) and the years after the valve replacement (X) in patients with porcine xenograft valves demonstrated a significant relationship (Y_1=0.1X+1.4, r=0.62, P<0.01; Y_2=0.7X+7.8, r=0.60, P<0.01 and Y_3=0.3X+3.3, r=0.50, P<0.01, respectively). II: Prosthetic aortic valve. To evaluate the opening function of prosthetic valves in the aortic position, the aortic flow velocity pattern was obtained with continuous wave Doppler echocardiography in 40 patients with prosthetic aortic valves (21 patients with Björk-Shiley valves, 12 patients with St. Jude Medical valves and 7 patients with Carpentier-Edwards valves) and in 25 normal subjects. The peak flow velocity across the aortic valve was recorded from the left ventricular apex, the suprasternal notch and the right parasternal border in the second intercostal space. The highest value was judged to be the peak flow velocity in each patient. The peak and mean pressure gradients were measured from the peak flow velocity with a simplified Bernoulli equation. The results were as follows; 1. The values of the peak flow velocity, the peak and mean pressure gradient in patients with Björk-Shiley valves (2.5±0.6 m/sec, 26±12 mmHg and 14±6 mmHg, respectively), in patients with St. Jude Medical valves (2.7±0.4 m/sec, 30±9 mmHg and 16±5 mmHg, respectively) and in patients with Carpentier-Edwards valves (2.7±0.7 m/sec, 31±15 mmHg and 18±9 mmHg, respectively) were significantly larger than those in normal subjects (1.1±0.2 m/sec, 5±2 mmHg and 3±1 mmHg, respectively) (P<0.001). But there were no significant differences of the values among the 3 groups of prosthetic valve. 2. The correlation between the peak flow velocity (Y_1), the peak (Y_2) and mean (Y_3) pressure gradients and the valvular size (X) in patients with Björk-Shiley valves demonstrated a significant inverse relationship (Y_1=-0.4X+3.5, r=-0.62, P<0.01; Y_2=-6.8X+45.9, r=-0.60, P<0.01 and Y_3=-4.1X+25.7, r=-0.65, P<0.01, respectively). 3. All 3 indices did not change significantly within 2 years after the first examination in patients with prosthetic valves. In conclusion, continuous wave Doppler echocardiography is a useful noninvasive method for the quantitative assessment of the opening function of the prosthetic valves in the mitral and aortic position. |
|||||
| 内容記述言語 | en | |||||
| 要約 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | 医歯学総合研究科博士論文(医学) ; 学位取得日: 平成3年3月4日 | |||||
| 内容記述言語 | ja | |||||
| 収録雑誌名 |
ja : 鹿児島大学医学雑誌 en : Medical journal of Kagoshima University 巻 42, 号 3, p. 285-304, 発行日 1991 |
|||||
| 作成日 | ||||||
| 日付 | 1991-03-04 | |||||
| 日付タイプ | Issued | |||||
| ISSN | ||||||
| 収録物識別子タイプ | PISSN | |||||
| ISSN | 0368-5063 | |||||
| NII書誌ID（雑誌） | ||||||
| 収録物識別子タイプ | NCID | |||||
| NC ID | AN00040104 | |||||
| 出版タイプ | ||||||
| 出版タイプ | VoR | |||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
| NDC | ||||||
| 主題Scheme | NDC | |||||
| 主題 | 493 | |||||
| 公開者・出版者 | ||||||
| 出版者 | 鹿児島大学 | |||||
| 出版者言語 | ja | |||||
| 公開者・出版者 | ||||||
| 出版者 | カゴシマ ダイガク | |||||
| 出版者言語 | ja-Kana | |||||
| 公開者・出版者 | ||||||
| 出版者 | Kagoshima University | |||||
| 出版者言語 | en | |||||
| 関連（relation）（relationType設定なし） | ||||||
| 識別子タイプ | URI | |||||
| 関連識別子 | http://id.ndl.go.jp/bib/000000248079 | |||||
| 関連（isVersionOf） | ||||||
| 関連タイプ | isVersionOf | |||||
| 識別子タイプ | URI | |||||
| 関連識別子 | http://dl.ndl.go.jp/info:ndljp/pid/3087614 | |||||
| 備考 | ||||||
| 備考 | 指導教員: 田中弘允 ; 平成22年度に行われた国立国会図書館の学位論文（博士）デジタル化事業に際し、著者から、学位授与大学において、国立国会図書館から譲渡を受けた学位論文のデジタル化複製物を利用（全文複写提供、公衆送信）に供することの許諾を受けたものです（参考：http://www.ndl.go.jp/jp/aboutus/digitization_theses.html）。 | |||||
| 学位記番号 | ||||||
| 学位記番号 | 医論第884号 | |||||
| 学位授与年月日 | ||||||
| 学位授与年月日 | 1991-03-04 | |||||
