Author |
김병태(Byung Tae Kim),궁성수(Sung Soo Koong),범희승(Hee Seung Bom),정준기(June Key Chung),박영배(Young Bae Park),이명철(Myung Chul Lee),이영우(Young Woo Lee),고창순(Chang Soon Koh), |
Abstract |
For measurement of ventricular performance, ejection
fraction (EF) has gained wide acceptance. But EF is
influenced not only by changes in muscle function but
also by changes in cardiac loading conditions. In case
of valvular geart disease which is variable in loading
conditions, EF cannot be reliable as an index of
myocardial contractility. The end systolic pressure
(ESP)-end systolic volume (ESV) relation, howver, is
known to represent myocardial contractility,
independent of changes in loading conditions. Similar
results can be obtained by using peak-systolic presure
(PSP) instead of ESP. To evaluate the utility of the
peak systolic pressure-end systolic volume index (PSP-
ESVI) relation as an index of myocardial function, we
measured PSP & ESVI in 19 partents with coronary artery
disease before (PSP& ESVI) and after (PSP & ESVI)
sublingeal administration of nitroglycerin, PSP was
measured with standard mercury sphygmomanometer during
gated blood pool scintigraphic study. ESVI was measured
by count derived method after attenuation correction.
PSP & ESVI measurement was started when the fall of PSP
was greater than 5 mmHg after 7-14 minutes post-
administration of nitroglycerin. Mean values ( + -
S.D.) of PSP & ESVI was 124.9( + - 20.7) mmHg 59.4(+-
39.9) ml/M2. Mean values ( + - S.D) of PSP & ESVI was
113.2(+ - 19.9)mmHg & 37.5(+ - 26.1)ml/M2. There was a
significant difference between mean values of PSP & PSP
(p<0.01), and mean values of ESVI & ESVI (p<0.01)PSP-
PSP/ESVI-ESVI, PSP/ESVI and EF were in the range of
0.14-5.19 mmHg/ml/M2, 0.67-7.68 mmHg/ml/M2 and
10.8%-74.5% respectively. PSP-PSP/ESVI-ESVI and EF
showed exponetial correlation (r=0.85, P<0.01). The
correlation coefficient between PSP/ESVI and EF was
0.73(p<0.01). With the above results, we suggest that
PSP1-PSP2/ESVI1-ESVI2 and PSP1/ESV1 can be usde as an
index of myocardial function. |