講演情報
[I-OR09-03]TPVI前後のエネルギー損失
○椎名 由美1,2, 小暮 智仁2, 川本 尚宣2, 朝貝 省史2, 稲井 慶2 (1.聖路加国際病院 循環器内科, 2.東京女子医大)
キーワード：
TPVI、Energy Loss、ACHD
Background: Energy loss (EL) is the energy dissipated by blood viscosity, and evaluates the cardiac workload which integrates both afterload and preload. Aim: To evaluate the improvement of EL and cardiac power output after transcatheter pulmonary valve implantation (TPVI) in adult congenital heart disease (ACHD). Methods: Prospectively, 26 adult patients (43.1+/-15.8 years) with significant pulmonary regurgitation were enrolled including tetralogy of Fallot (TOF), double outlet right ventricle, and pulmonary stenosis. Magnetic resonance imaging (MRI) scans were performed before and 3 months after TPVI. They also had diagnostic catheterization before and after TPVI, and cardiac power output（CPO）was estimated using catheterization data. Results: CPO increased from 71.5+/-38.7 to 122.0+/-56.8mW. Average Right heart EL also improved from 10.6+/-8.1 to 5.7+/-3.1mW(P=0.04). EL/CPO was significantly improved from 16.7+/-4.7 to 4.7+/-4.8%, which is believed to be an objective marker of cardiac burden. EL in Healthy TOF shows is below 5.0% of the entire energy. RV size was significantly decreased after TPVI; however, there was no significant difference in RVEF, left ventricle (LV) size, LVEF, and brain natriuretic peptide. Conclusions: Even though conventional MRI parameters did not change 3 months after TPVI, EL/CO was significantly improved from a fluid dynamics perspective, which reached the ideal situation (less than 5.0%). This novel parameter can follow the temporal changes in each ACHD patient and can calculate the percentage of cardiac burden.