Diastolische Ventrikelfunktion bei koronarchirurgischen Patienten vor und nach extrakorporaler Zirkulation: Vergleich dopplersonographisch und invasiv bestimmter Parameter der diastolischen Ventrikelfunktion
| Autor: | Hans Sonntag, Michael Sydow, W. Buhre, Stephan Kazmaier, Th. Busch, M. Ferrari, G. G. Hanekop, B. Schorn, M. Nowak |
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| Rok vydání: | 1999 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Diastole Cardiac index 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine Heart rate Cardiopulmonary bypass medicine cardiovascular diseases 030212 general & internal medicine E/A ratio business.industry Cardiac surgery surgical procedures operative Cardiothoracic surgery Anesthesia cardiovascular system Ventricular pressure Cardiology Surgery Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology |
| Zdroj: | Zeitschrift f�r Herz-, Thorax- und Gef��chirurgie. 13:S042-S047 |
| ISSN: | 1435-1277 0930-9225 |
| DOI: | 10.1007/s003980050117 |
| Popis: | There is evidence that diastolic function is a major determinant of overall cardiac performance. Intraoperative use of transesophageal echocardiography (TEE) enables Doppler measurement of mitral inflow pattern (E/A ratio). The E/A ratio is suggested to be a reliable index of changes in myocardial relaxation. In the present study we compared the time course of the E/A ratio and the time constant of myocardial relaxation (τ) assessed by direct left ventricular pressure recordings in patients before and after cardiopulmonary bypass (CPB). After ethical approval, 12 patients undergoing CABG surgery were studied. Measurements of the E/A ratio and τ were performed after induction of anesthesia (I), immediately prior to CPB with the pericardium open (II), 5 min after CPB (III), and after sternal closure (IV). Time constant of myocardial relaxation was calculated as the reciprocal value of the slope of the left ventricular dP/dt and left ventricular pressure plot. The E/A ratio was significantly decreased at the end of surgery (IV). In contrast, τ was increased immediately after CPB, but decreased after sternal closure (IV). Cardiac index and heart rate both increased after CPB.¶ The results of the present study demonstrate that diastolic dysfunction occurred immediately after CPB, as indicated by an increase in the time constant of myocardial relaxation. However, τ improved rapidly to pre-CPB values. The E/A ratio alone failed to detect the initial post-CPB alteration in left ventricular relaxation. |
| Databáze: | OpenAIRE |
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