抄録
In an attempt to examine the extent to which the right heart performance can predict the left heart performance in heart diseases primarily affecting the left heart, we recorded cardiac index-venous pressure (CI-VP) plot and cardiac index-mean pulmonary artery wedge pressure (CI-PAW) plot at rest and investigated the shift of CI-VP plot and CI-PAW plot that occurred during mild dynamic exercise of the lower limbs. Six patients had normal heart function and 20 patients had heart disease primarily affecting the left heart. The sensitivity, specificity, positive predictive value and negative predictive value in the estimation of the left heart function with ΔCI/ΔVP were 80%, 100%, 89% and 100%, respectively, when ΔCI/PAW was regarded as the golden standard for the estimation of the left heart function. The sensitivity, specificity, positive predictive value and negative predictive value in estimating the left heart function with ΔCI/ΔRA were 86%, 93%, 92% and 86%, respectively. When the left heart function was estimated by ΔVP alone without measuring ΔCI, the sensitivity, specificity positive predictive value and negative predictive value were 40%, 100%, 73% and 100%, respectively. In short, it was possible to predict the left heart dysfunction with ΔCI/ΔVP or ΔCI/ΔRA, in the presence of the right heart dysfunction. It was also possible to predict a steep heart slope from normal ΔCL/ΔVP with error of 2/18 (11%), when steep left heart slope was predicted, based on the presence of steep right heart slop. In comparison, ΔVP alone was a less sensitive index of the performance of the left heart.
