ID 109593
著者
ハラ, トモヤ Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
キシ タナカ, クミコ Department of Gastroenterology and Oncology, Institute of Health Biosciences, the University of Tokushima Graduate School
イワセ, タカシ Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School KAKEN研究者をさがす
山田, 博胤 Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School 徳島大学 教育研究者総覧 KAKEN研究者をさがす
赤池, 雅史 Department of Medical Education, Institute of Health Biosciences, the University of Tokushima Graduate School 徳島大学 教育研究者総覧 KAKEN研究者をさがす
佐田, 政隆 Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School 徳島大学 教育研究者総覧 KAKEN研究者をさがす
キーワード
diastolic heart failure
lower limb positive pressure test
apical hypertrophic cardiomyopathy
資料タイプ
学術雑誌論文
抄録
A 70-year-old woman with dyspnea on exertion was admitted to our hospital. She had a history of apical hypertrophic cardiomyopathy (HCM) and repeated hospitalization for heart failure. Results of physical examination were normal except for leg edema. Echocardiography showed apical HCM with preserved LV systolic function (LVEF=70%). Although dyspnea on exertion and leg edema improved rapidly with the use of diuretics, her symptoms soon worsened when daily activity was started again. In order to examine the effect of preload on hemodynamics, we performed a lower limb positive pressure test by compressing both legs using a household air leg massager. Echocardiography showed increases in mitral E velocity, E/A ratio and pulmonary venous D flow as well as decrease in stroke volume during the lower limb positive pressure test. Simultaneously-recorded pressure study also showed elevated LVEDP and increased v wave of pulmonary capillary wedge pressure. These results suggested that even a small increase in preload led to elevation of LVEDP and symptomatic worsening due to severe diastolic heart failure in the present case. The lower limb positive pressure test may be useful for assessing the effect of preload on hemodynamics in patients with diastolic heart failure.
掲載誌名
The journal of medical investigation : JMI
ISSN
13431420
cat書誌ID
AA11166929
出版者
The University of Tokushima Faculty of Medicine
61
3-4
開始ページ
404
終了ページ
408
並び順
404
発行日
2014-08
EDB ID
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
病院
医学系