徳島大学 教育・研究者情報データベース(EDB)

1. (英) Hara T

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2. (英) Kishi-Tanaka K

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3. 岩瀬 俊

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4. 山田 博胤([徳島大学.大学院医歯薬学研究部.医学域.連携研究部門(医学域).寄附講座系(医学域).地域循環器内科学])

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5. 赤池 雅史([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.社会医学系.医療教育学])

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6. 佐田 政隆([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.内科系.循環器内科学])

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(英) Utility of lower limb positive pressure test for diagnosis of diastolic heart failure: a case report.

(英) 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.

1. (英) diastolic heart failure
2. (英) lower limb positive pressure test
3. (英) apical hypertrophic cardiomyopathy

1. (英) Article.PublicationTypeList.PublicationType: Journal Article