先发制人的enoximone对左心室舒张功能的影响在瓣膜置换主动脉瓣狭窄。

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van der Maaten JM,德弗里斯AJ, Rietman GW, Gallandat休伊特RC de伤害SG的

先发制人的enoximone对左心室舒张功能的影响在瓣膜置换主动脉瓣狭窄。

J Cardiothorac Vasc Anesth。2007年6月,21 (3):357 - 66。2006年5月4日Epub。

PubMed ID

17544886 (在PubMed

]

文摘

目的:左心室(LV)肥大与主动脉瓣置换术后早期舒张压室刚度增加瓣膜狭窄。Enoximone第三磷酸二酯酶抑制剂,可以改善心肌收缩和放松当管理作为心脏手术后单剂量。目前的研究调查,分析transmitral流速模式和舒张末期压力区关系,enoximone管理主动脉瓣手术前是否对LV舒张性能产生影响。设计:前瞻性随机研究。设置:转诊中心大学医院心胸外科。参与者:34接受主动脉瓣置换术的患者主动脉瓣狭窄。干预:病人enoximone组(n = 17)收到丸剂量为0.35毫克/公斤(0.15毫克/公斤主动脉cross-clamping和0.2毫克/公斤之前添加到cardioplegic解决方案)。个人压力区关系(肺毛细血管楔压v左心室舒张区)通过使用体积在装货之前腿高度和封闭的胸部手术后。测量及主要结果:压力区情节上的压力区关系转移到左边的手术后,指示LV舒张压下降enoximone膨胀性和对照组和提供LV舒张功能下降的证据。指数的LV舒张压室刚度、LV操作刚度(K (LV))来源于早期心室充盈性的减速时间,和室的常数刚度(β)来自压力区enoximone治疗后没有不同的关系。 Systolic LV function was unaltered after cardiac surgery in both groups. Analysis of changes in transmitral flow patterns identified an increased atrial filling fraction in enoximone-treated patients, suggesting increased atrial systolic function. The unaltered systolic pulmonary venous flow velocity compared with the decrease in the control group after volume loading further supports preservation of left atrial reservoir function with enoximone in the absence of evidence for decreased LV stiffness. CONCLUSION: Preemptive enoximone did not change LV diastolic function based on diastolic filling patterns or LV stiffness indices (K(LV) and beta) derived from Doppler early filling deceleration time and pressure-area relations. Doppler data suggested improvement of left atrial systolic function and preservation of left atrial reservoir function with enoximone.

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Enoximone