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DOI: 10.1055/s-0038-1629546
Multiparameteranalyse mittels Radionuklidventrikulographie in der Beurteilung der linksventrikulären Funktion nach Herztransplantation
Multiparameter Analysis and Radionuclide Ventriculography in the Evaluation of Left Ventricular Function Following Cardiac TransplantationPublication History
Eingegangen:
14 September 1990
Publication Date:
04 February 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034924/199101/lookinside/thumbnails/10-1055-s-0038-1629546_de-1.jpg)
Left ventricular systolic and diastolic performance was evaluated by radionuclide angiography in 17 patients following cardiac transplantation and compared with normal persons. Both groups performed supine bicycle exercise during the investigation, the control group at 102 ± 73 W and the transplanted patients at 61.2 ± 15 W. The ejection fraction increased in the normal persons from 61 ± 8 to 69 ± 10% whereas in the transplanted patients it did not increase significantly. There were no relevant changes in systolic parameters during exercise in the transplant recipients. The changes in diastolic parameters were significantly smaller in transplant patients than in normals. After correction for heart rate-induced changes a significantly different time course of the systolic-diastolic sequence during the cardiac cycle became evident in the transplanted group at rest. During exercise the systolic-diastolic sequence during the cardiac cycle became similar in both groups. It is concluded that the reduced exercise capacity of patients in the late phase after cardiac transplantation is partially due to the absence of an EF increase and a limitation of diastolic reserve during exercise.
Zusammenfassung
Linksventrikuläre Funktionsparameter wurden bei 17 Patienten nach Herztransplantation mittels Radionuklidventrikulographie untersucht. Ein Vergleichskollektiv leistete 102 ± 73 Watt und die transplantierten Patienten 61,2 ± 15 Watt. Die EF stieg bei den Normalpersonen unter Belastung von 61 ± 8 auf 69 ± 10%, während sie sich bei den herztransplantierten Patienten nicht signifikant änderte. Systolisch waren bei den transplantierten Patienten keine wesentlichen Unterschiede zwischen Ruhe und Belastung zu verzeichnen. Die diastolischen Relaxationsparameter nahmen unter Belastung bei den transplantierten Patienten weniger zu als im Normalkollektiv. Um einen Einfluß der unterschiedlichen Herzfrequenz in beiden Kollektiven in der Analyse des Kontraktions-Relaxationsablaufes während des kardialen Zyklus auszuschließen, wurden die systolischen und diastolischen Parameter auf die Länge des RR-Abstandes bezogen. Nach Frequenzkorrektur fand sich ein unterschiedlicher Kontraktionsablauf in Ruhe bei den transplantierten Patienten. Unter Belastungsbedingungen kam es zu einer zeitlichen »Synchronisation« des kardialen Zyklus der beiden Kollektive. Es wird gefolgert, daß mit der Radionuklidventrikulographie eine Beurteilung von linksventrikulären systolischen und diastolischen Funktionsparametern möglich ist. Es findet sich ein fehlender EF-Anstieg unter Belastung sowie eine Einschränkung der diastolischen Reserve.
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