JPWO2006054342A1 - Heart disease diagnosis system - Google Patents

Abstract

An object of the present invention is to provide a heart disease diagnosis system that makes it possible to accurately diagnose the cause of an abnormality of a heart disease by analyzing the hemodynamics of the patient. This heart disease diagnosis system includes an input means 2 for inputting a cardiac output value of a patient, a left atrial pressure value and / or a right atrial pressure value, and the inputted cardiac output value and left atrial pressure value. Alternatively, the first calculation means 31 for calculating the left heart function value or the right heart function value from the right atrial pressure value, and the left heart function value and / or the right heart function value calculated by the first calculation means 31 are displayed. It is characterized by comprising display means 4.

Description

  The present invention relates to a heart disease diagnosis system, and more particularly, to a heart disease diagnosis system that makes it possible to accurately diagnose the cause of heart disease abnormality by analyzing the hemodynamics of a patient.

It is known that emergency treatment by a specialist in the acute phase is extremely effective for heart disease. However, only 3% of all doctors are capable of dealing with heart disease, and the treatment is not sufficient.
For this reason, even general practitioners need to acquire the ability level corresponding to the same level of heart disease as specialists.
However, it is extremely difficult for general practitioners to reach the same level of competence as the above specialists, and heart disease diagnosis is performed to raise the ability level corresponding to heart diseases performed by general practitioners to the specialist's ability level. System development is desired.

  As a heart disease diagnosis system for solving the above-described problems, an ultrasonic diagnostic apparatus disclosed in Patent Document 1 has been created. The ultrasonic diagnostic apparatus disclosed in Patent Document 1 is intended to diagnose a heart disease by measuring a blood vessel diameter and a change rate thereof. However, the ultrasonic device as described in Patent Document 1 cannot be easily introduced due to problems such as high cost because the device itself is a large device, and the intrinsic function of the heart. -It was impossible to evaluate the internal structure of the circulatory system such as vascular resistance and effective circulatory blood volume, and the above problems could not be solved.

On the other hand, Guyton et al. Established a basic circulatory equilibrium theory using cardiac output curves, venous return curves, etc. in the 1950s. (Non-Patent Document 1).
However, in the basic circulatory equilibrium theory by Guyton, blood movement between the lung and systemic circulation is not taken into consideration, and it is impossible to predict the left atrial pressure (pulmonary artery wedge pressure) that influences the prognosis. . For this reason, there is a problem that accurate treatment cannot be performed.

In addition, there are many devices that can display hemodynamic abnormalities by measuring cardiac output, left atrial pressure, blood pressure, heart rate, and the like. However, a device that diagnoses the internal structure of the circulatory system to determine whether the hemodynamic abnormality is caused by cardiac function or the effective circulating blood volume even if the numerical value of hemodynamic abnormality is displayed is It was the current situation that was not created.
For this reason, even if the values of hemodynamic abnormalities as described above are measured, the diagnosis of where the abnormality is in the circulatory system is made by each specialist, and there is no clear standard at present. there were.

JP 2002-17728 A Guyton AC. "Determination of cardiac output by equating venous return curves with cardiac response curves" Physiol Rev 35: 123-129, 1955

  The present invention has been made in view of such circumstances, and by analyzing a patient's hemodynamics (blood pressure, cardiac output, right atrial pressure and left atrial pressure), cardiac function, effective circulating blood volume, The present invention relates to a heart disease diagnosis system that makes it possible to accurately calculate a cause of abnormality of heart disease by calculating vascular resistance.

The invention according to claim 1 is the input means 2 for inputting the cardiac output value of the patient, the left atrial pressure value and / or the right atrial pressure value, and the inputted cardiac output value and the left atrial pressure. The first calculation means 31 for calculating the left heart function value or the right heart function value from the value or the right atrial pressure value, and the left heart function value and / or the right heart function value calculated by the first calculation means 31 are displayed. A heart disease diagnosis system comprising display means 4 is provided.
According to a second aspect of the present invention, the first calculating unit 31 calculates (Equation 1) and / or from the cardiac output value input from the input unit 2 and the left atrial pressure value and / or the right atrial pressure value. Alternatively, the left heart function value and / or the right heart function value is calculated using (Equation 2), and the heart disease diagnosis system according to claim 1 is provided.

According to the third aspect of the present invention, the input means 2 for inputting the cardiac output value, the left atrial pressure value, and the right atrial pressure value of the patient, the input cardiac output value, the left atrial pressure value, and the right Provided is a heart disease diagnosis system comprising a second calculating means 32 for calculating an effective circulating blood volume value from an atrial pressure value and a display means 4 for displaying an effective circulating blood volume value calculated by the second calculating means 32. To do.
In the invention according to claim 4, the second calculation means 32 uses (Equation 3) from the cardiac output value inputted from the input means 2, the left atrial pressure value, and the right atrial pressure value, The cardiac disease diagnosis system according to claim 3, wherein the effective circulating blood volume value is calculated.

The invention according to claim 5 is calculated by the third calculation means 33 for calculating a vascular resistance value from the inputted cardiac output value, the right atrial pressure value and the blood pressure value, and the third calculation means 33. There is provided a heart disease diagnosis system comprising display means 4 for displaying a vascular resistance value.
The invention according to claim 6 is characterized in that the third calculating means 33 uses the expression (4) from the cardiac output value, the right atrial pressure value and the blood pressure value input from the input means 2 to calculate the vascular resistance. The value is calculated, and the heart disease diagnosis system according to claim 5 is provided.

The invention described in claim 7 provides a heart disease diagnosis system characterized by combining two or three systems from the systems 1 described in claims 1, 3 and 5.
The invention according to claim 8 is characterized in that the display means 4 displays each numerical value calculated from each of the calculating means 31, 32, 33 continuously in time series. A heart disease diagnosis system according to claim 1 is provided.
The invention according to claim 9 is characterized in that the cardiac output is measured by a Swan-Ganz = catheter or calculated from an diastolic time constant of an arterial blood pressure waveform. The heart disease diagnosis system described in 1. is provided.
In the invention according to claim 10, the left atrial pressure value is directly measured by a catheter or is calculated by continuously estimating a pulmonary artery wedge pressure by a Swan-Ganz = catheter or a diastolic pressure value of a pulmonary artery pressure. A heart disease diagnosis system according to any one of claims 1 to 8, wherein the heart disease diagnosis system is provided.
By providing these inventions, the above problems can be solved.

According to the first aspect of the present invention, the left heart function and / or right heart function of the patient is determined as the left heart function value and / or the cardiac output and the left atrial pressure and / or the right atrial pressure as input values. Since it can be calculated as a right heart function value, a heart disease diagnosis system capable of expressing a patient's heart function using specific numerical values is provided.
In this way, by expressing the left and right heart functions as specific numerical values, even a general doctor can easily diagnose the left and right heart functions of the patient.
According to the invention described in claim 2, by using (Equation 1) and (Equation 2), the cardiac function can be calculated in more detail and clearly, and the constants A to D are appropriately changed. Thus, it is possible to provide a cardiac disease diagnosis system that can calculate and correct cardiac function values calculated according to various patients.
Since the cardiac function value calculated in this way can be corrected according to the patient, a more accurate cardiac function of the patient can be calculated.

According to the invention described in claim 3, since the cardiac output, the left atrial pressure, and the right atrial pressure are input values, the patient's effective circulating blood volume can be calculated as the effective circulating blood volume value. Provided is a heart disease diagnosis system capable of expressing the effective circulating blood volume flowing through the body using specific numerical values.
Thus, by expressing the effective circulating blood volume as a specific numerical value, a general physician can easily diagnose the effective circulating blood volume of the patient.
According to the invention of claim 4, by using (Equation 3), it is possible to calculate the effective circulating blood volume in more detail and clearly, and by appropriately changing the constants E to G, Provided is a heart disease diagnosis system capable of calculating an effective circulating blood volume calculated according to various patients.
Since the effective circulating blood volume value calculated in this way can be corrected according to the patient, the more accurate effective circulating blood volume of the patient can be calculated.

According to the fifth aspect of the present invention, the vascular resistance of the patient can be calculated as the vascular resistance value by using the cardiac output, the right atrial pressure, and the blood pressure as input values. A heart disease diagnosis system that can be expressed using various numerical values is provided.
Thus, by expressing the vascular resistance with specific numerical values, a general physician can easily diagnose the vascular resistance of the patient.
The invention according to claim 6 provides a heart disease diagnosis system that can calculate the vascular resistance value in more detail and clearly by using (Equation 4).

According to the seventh aspect of the present invention, the patient's left heart function and / or right heart function, effective circulating blood volume, vascular resistance, and the like are calculated from the cardiac output, right atrial pressure and / or left atrial pressure, and blood pressure. It is possible to provide a heart disease diagnosis system capable of
Thus, since the left heart function and / or right heart function, effective circulating blood volume and vascular resistance of the patient can be displayed as specific numerical values, even a general physician can easily make a diagnosis. .
According to the invention described in claim 8, the left heart function and / or the right heart function, the effective circulating blood volume and the vascular resistance can be displayed continuously in time series, so that the time series change is overlooked. A heart disease diagnosis system capable of reliably diagnosing a patient without any problem is provided.
According to the inventions of claims 9 and 10, the cardiac output is measured by Swan-Ganz = catheter or calculated from the diastolic time constant of the arterial blood pressure waveform, and the left atrial pressure value is directly measured by the catheter Alternatively, since it is calculated by continuous estimation from the pulmonary artery wedge pressure by the catheter or the diastolic pressure value of the pulmonary artery pressure, a highly accurate heart disease diagnosis system can be provided.

The best mode for carrying out the present invention will be described.
FIG. 1 is a schematic configuration diagram of a heart disease diagnosis system according to the present invention. FIG. 2 shows a schematic diagram of the heart, and the heart disease diagnosis system (1) according to the present invention provides the cardiac output value, left atrial pressure value, right atrial pressure value, and blood pressure shown in FIG. Use a value (not shown).
By using the heart disease diagnosis system (1) according to the present invention, hemodynamic abnormalities (decreased cardiac output (peripheral circulatory failure), increased left atrial pressure (pulmonary congestion) and increased or decreased blood pressure) It can be diagnosed whether the cause is left heart function or right heart function, an abnormality in effective circulating blood volume, or vascular resistance.
The heart disease diagnosis system (1) according to the present invention comprises an input means (2), a calculation means (3), and a display means (4).

The input means (2) inputs hemodynamic values (numerical data) measured from the patient to the calculation means (3) described later. The hemodynamic values input by the input means (2) are set as a blood pressure value, a cardiac output value, a right atrial pressure value, and a left atrial pressure value.
The input means (2) is not particularly limited as long as numerical data can be input to the calculation means (3), and the actually measured numerical values are used using the heart disease diagnosis system (1). An input device such as a keyboard input by the person can be employed, or a measuring device that measures the patient's hemodynamics and directly inputs it to the calculation means (3) can be employed.
The hemodynamic numerical data input by the input means (2) is a blood pressure value, a cardiac output value, a right atrial pressure value, and a left atrial pressure value, and a conventional measuring device can be used for each. Such a measuring device is not particularly limited, but the blood pressure value can be measured by placing a catheter in a peripheral artery (for example, radial artery), and the cardiac output value, left atrial pressure value The right atrial pressure can be measured using a Swan Ganz catheter. The cardiac output value can also be measured from the diastolic time constant of the arterial blood pressure waveform.

The heart disease diagnosis system (1) according to the present invention measures and uses each numerical value as a continuous numerical value in order to continuously diagnose a patient. At this time, the blood pressure value and the right atrial pressure value can be measured continuously, but conventionally, the left atrial pressure value and the cardiac output value cannot be measured continuously.
Therefore, the left atrial pressure value is used as a continuous numerical value by adopting a method of continuously estimating the left atrial pressure value by continuously estimating from the diastolic pressure value of the pulmonary artery pressure.
Since the left atrial pressure value is known to have a linear relationship with the diastolic pressure value of the pulmonary artery pressure, the left atrial pressure value is calculated from the pulmonary artery diastolic pressure based on the average correlation of multiple individuals. be able to. When the left atrial pressure value is calculated using the diastolic pressure value of the pulmonary artery pressure, the correlation (linear relationship) between the diastolic pressure value of the pulmonary artery pressure and the left atrial pressure value changes according to the change in the heart rate. Therefore, it is preferable that the average correlation among a plurality of individuals can be corrected by the heart rate.
Further, the cardiac output value is used as a continuous numerical value by adopting a method of estimating from the diastolic time constant of the peripheral blood pressure waveform.
For this cardiac output value, a conventionally known method can be adopted, and for example, it can be calculated using a diastolic time constant of a peripheral blood pressure waveform.

  The calculation means (3) calculates the hemodynamic value input from the input means (2) by a predetermined method. The calculation means (3) includes a first calculation means (31), a second calculation means (32), and a third calculation means (33). The calculation means (3) may be set to perform the calculations of the first to third calculation means (31 to 33) as one calculation unit, or the first to third calculation means (31 to 33). It may be composed of three arithmetic units that respectively perform the above operations.

  The first calculation means (31) calculates a left heart function value from the cardiac output value and the left atrial pressure value input from the input means (2). Alternatively, the right heart function is calculated from the cardiac output value and the right atrial pressure value input by the input means (2). The first calculation means (31) may be set so as to be able to calculate the left heart function value and the right heart function value, respectively, and either the left heart function value or the right heart function value is set. You may set so that it may calculate.

The method of calculating the left heart function value performed by the first calculation means (31) is expressed by the following (Equation 5) using the cardiac output value and the left atrial pressure value input by the input means (2). By substituting these numerical values, the left heart function value can be calculated.
A and B in this equation (Equation 5) are constant values (constants), which are numerical values that can be appropriately changed depending on the patient. This constant is a numerical value set in advance by the user and can be changed according to the patient. Therefore, the left heart function value calculated by adjusting according to the patient can be corrected.

  When using the above mathematical formula, the mathematical formula such as the following (Equation 6) is converted and set so that the left heart function value is calculated from the numerical value input from the input means (2). Is preferred. This is because the arithmetic processing can be performed quickly by using the mathematical formula thus converted.

The first calculation means (31) can calculate the left heart function value as described above, and similarly can calculate the right heart function value using the following (Equation 7). When calculating the right heart function value, the cardiac output value and the right atrial pressure value are used and calculated by substituting into (Equation 7).
Also in this case, the first calculation means (31) is provided with (Expression 8) obtained by converting (Expression 7), and the right heart function value is calculated from the numerical value input from the input means (2). It is preferable to set to.
Note that C and D in the formulas of (Equation 7) and (Equation 8) are constant values (constants), and can be appropriately changed depending on the patient. This constant is a numerical value set in advance by the user and can be changed according to the patient. Therefore, the right heart function value calculated by adjusting according to the patient can be corrected.

This first calculation means (31) calculates the left heart function value and the right heart function value, both of which can be calculated using the cardiac output value, and is shown in FIG. As described above, the “cardiac output” value, the “left atrial pressure” value, and the “right atrial pressure” value can be expressed by three-dimensional coordinates having three axes.
As described above, the “cardiac output” value, the “left atrial pressure” value, and the “right atrial pressure” value are expressed by three-dimensional coordinates having three axes, thereby displaying a change in cardiac output. The output curve can be displayed. By displaying this cardiac output curve, the left heart function and the right heart function of the patient can be viewed in an integrated manner, and diagnosis can be performed very easily.
FIG. 3 shows a normal cardiac output curve (a) and a cardiac output curve (b) of a damaged heart. From the cardiac output curve of FIG. It can be easily understood that the cardiac output curve of (b) has a lower function that integrates the left and right cardiac functions. Thus, diagnosis can be easily performed by designating a normal cardiac output curve and a measured cardiac output curve in one space.

The calculating means (3) has second calculating means (32).
The second calculating means (32) calculates an effective circulating blood volume value from the cardiac output value, the left atrial pressure value, and the right atrial pressure value.
The second calculating means (32) calculates the effective circulating blood volume value using the cardiac output value, the left atrial pressure value, and the right atrial pressure value input by the input means (2) as follows. By substituting these numerical values into (Equation 9), the effective circulating blood volume value can be calculated.
E, F, and G in this formula (Equation 9) are constant values (constants), and are values that can be appropriately changed according to the patient. This constant is a numerical value set in advance by the user and can be changed according to the patient. Therefore, the effective circulating blood volume value calculated by adjusting according to the patient can be corrected.

  When using the above equation (Equation 9), an equation such as the following (Equation 10) is converted, and the effective circulating blood volume value is calculated from the numerical value input from the input means (2). It is preferable to set. This is because the arithmetic processing can be performed quickly by using the mathematical formula thus converted.

The second calculating means (32) calculates using the cardiac output value, the right atrial pressure value, and the left atrial pressure value. As shown in FIG. 4, the “cardiac output” value, “left It can be expressed in three-dimensional coordinates with the “atrial pressure” value and the “right atrial pressure” value as three axes. In this case, since the three variables of “cardiac output” value, “left atrial pressure” value, and “right atrial pressure” value are handled, as shown in FIG. Plane).
This plane is formed by three variables of “cardiac output” value, “left atrial pressure” value and “right atrial pressure” value, and constants (E, F and G). It has been found that the inclination of this plane can be considered constant between different individuals or within the same individual.
Therefore, since this venous return plane has a constant inclination, the height of the plane is determined by the calculated effective circulating blood volume value.
Thus, by expressing the “cardiac output” value, the “left atrial pressure” value, and the “right atrial pressure” value by three-dimensional coordinates having three axes, the effective circulating blood volume is displayed as a venous return plane. And the patient's effective circulating blood volume (venous return plane) can be visually observed, and diagnosis can be performed very easily.
FIG. 4 shows a normal venous return plane (c) and a venous return plane (d) in which the effective circulating blood volume has increased, and the venous return plane of (d) rather than (c). It is shown that the height is higher. Thus, diagnosis can be easily performed by designating the normal venous return plane and the measured venous return plane in one space.

The calculating means (3) has third calculating means (33).
The third calculation means (33) calculates a vascular resistance value from the cardiac output value, the right atrial pressure value, and the blood pressure value.
The third calculation means (33) calculates the vascular resistance value by using the cardiac output value, right atrial pressure value and blood pressure value input by the input means (2), By substituting these numerical values into, the vascular resistance value can be calculated.
H in this equation (Equation 11) is a constant value (constant), which is a numerical value that can be appropriately changed according to the patient. This constant is a numerical value set in advance by the user and can be changed according to the patient. Therefore, the vascular resistance value calculated by adjusting according to the patient can be corrected.

FIG. 5 shows a cardiac output curve (e) and a venous return plane (f) in a three-dimensional coordinate system having the “cardiac output” value, the “left atrial pressure” value, and the “right atrial pressure” value as three axes. ) Is displayed at the same time.
In FIG. 5, the “cardiac output” value, “left atrial pressure” value and “right atrial pressure” value of the individual are determined from the intersection of the cardiac output curve (e) and the venous return plane (f). . If the individual's “cardiac output” value, “left atrial pressure” value and “right atrial pressure” value are abnormal and they are to be improved to some normal value, they are within the 3D coordinates corresponding to the normal value. Specify the target point. The individual cardiac output curve (e) and the venous return plane (f) are each administered and controlled so that the cardiac output curve (e) and the venous return plane (f) intersect at the target point. . As a result, the “cardiac output” value, the “left atrial pressure” value, and the “right atrial pressure” value can finally reach normal target values.

The display means (4) includes input numerical values (cardiac output value, left atrial pressure value, right atrial pressure value, blood pressure value) input from the input means (2) and the first to third calculation means described above. It is an output device which displays the calculated numerical value calculated | required by (31-33).
This display means (4) displays the calculated numerical values (cardiac function value, effective circulating blood volume value and vascular resistance value) calculated by the respective calculating means (31 to 33). Since the cardiac disease diagnosis system (1) according to the present invention can continuously measure the input numerical values from the patient as described above, the calculated numerical values are continuously calculated by the respective calculation means (31 to 33). For this reason, it is preferable to display a continuous line graph in time series by the display means (4).
In this way, by displaying a continuous line graph in time series, it is possible to visually confirm the time series change, so that the change can be easily grasped.
The above is the configuration of the heart disease diagnosis system (1) according to the present invention.

Next, the operation of the heart disease diagnosis system (1) according to the present invention will be described.
FIG. 6 shows a flowchart when the heart disease diagnosis system according to the present invention is used.
In the heart disease diagnosis system (1) according to the present invention, as described above, the constants A to G need to be set in actual use, but are omitted here.
First, a patient's blood pressure value, cardiac output value, right atrial pressure value, and left atrial pressure value are measured (S1).
At this time, these numerical values are measured by attaching a Swan Ganz catheter to the patient, but other devices may be used.
Next, the measured blood pressure value, cardiac output value, right atrial pressure value, and left atrial pressure value are input to the calculation means (3) by the input means (2), respectively.
When these measured numerical values are inputted by the input means (2), the left heart function value, the right heart function value, the effective circulating blood volume value and the vascular resistance value are calculated by the calculation means (3). Specifically, when the cardiac output value and the left atrial pressure value are input to the first calculation means (31), the left heart function value is calculated. Further, when the cardiac output value and the right atrial pressure value are input to the first calculation means (31), the right heart function value is calculated (S2).
When the cardiac output value, the left atrial pressure value, and the right atrial pressure value are input to the second calculating means (32), an effective circulating blood volume value is calculated (S3).
When the cardiac output value, the right atrial pressure value, and the blood pressure value are input to the third calculation means (33), a vascular resistance value is calculated (S4).
Each time these cardiac output value, left atrial pressure value, right atrial pressure value, and blood pressure value are measured, the first to third calculation means (31 to 33) continuously calculate the left heart function value, The right heart function value, effective circulating blood volume value and vascular resistance value are calculated.

When each calculation value (left heart function value, right heart function value, effective circulating blood volume value and vascular resistance value) is calculated by the calculation means (3), these calculation values are sent to the display means (4). The calculated numerical values sent to the display means (4) are each displayed in a continuous line graph in time series (S5).
Each calculated numerical value (left heart function value, right heart function value, effective circulatory blood volume value and vascular resistance value) is displayed as a line graph on the display means (4). By comparing with the threshold value, the patient's cardiac function, effective circulating blood volume, and vascular resistance can be continuously grasped, so that the patient can be diagnosed with certainty.
In particular, since the patient's cardiac function, effective circulating blood volume and vascular resistance values are specifically displayed, the cause of the patient's pathology can be ascertained and can be dealt with extremely appropriately and quickly. .
By displaying the normal values of the left heart function value, right heart function value, effective circulating blood volume value and vascular resistance value displayed on the display means (4) as threshold values, the calculated numerical value is within the normal value range. It can also be easily determined whether or not.

Test example 1

Next, the result of testing the heart disease diagnosis system (1) according to the present invention is shown.
In this test example, it is examined whether or not the mathematical formulas (the above (Formula 5) to (Formula 11)) used in the heart disease diagnosis system (1) according to the present invention are accurate.
In this test example, the effectiveness of these equations was examined using 7 dogs.
First, the constant A and the constant B expressed by (Equation 5) and (Equation 6) will be examined. These constant A and constant B are constants for calculating the left heart function value of the dog.
As shown in the following (Table 1), it is confirmed that the constants A and B can use “A = 2.03” and “B = 0.80” in the case of a dog.

Next, the constant C and the constant D expressed by (Equation 7) and (Equation 8) will be examined. These constant C and constant D are constants for calculating the right heart function value of the dog.
As shown in the following (Table 2), it is confirmed that the constant C and the constant D can use “C = 1.0” and “D = 0.88” in the case of a dog.
The “constant C” and “constant D” are numerical values obtained by performing linear regression on the above seven measured values and correcting them to practical use.

Next, the constant E, the constant F, and the constant G shown in (Equation 9) and (Equation 10) are examined. These constant E, constant F, and constant G indicate constants for calculating the effective circulating blood volume of the dog.
As shown in (Table 3) below, constant E, constant F and constant G may use “E = 0.129”, “F = 19.61”, “G = 3.49” in the case of dogs. It is confirmed that it can be done.

In this way, the constants A to G are respectively initialized. That is, if the dog is a subject (patient), the constants A to G in (Expression 5) to (Expression 10) are “A = 2.03”, “B = 0.80”, “C = 1.0”, “D = 0.88”, “E = 0.129”, “F = 19.61”, and “G = 0.49” are set. The constant H in (Equation 11) was set to “H = 0” in dogs according to the report of Shoukas et al. (For example, Shokas AA. “Carotid sinus baroreceptor reflex control and epinephrine. pulmonary vascular bed of the dog. "Circ Res 51: 95-101, 1982.). These constants are effective for dogs, and other constants are initially set for other animals (including humans).
When these constants are used, if the change in hemodynamic abnormality at the time of myocardial infarction of the dog as shown in FIG. 7 is shown, the effective circulating blood volume and the left heart function as shown in FIG. Right heart function and vascular resistance will be shown. If the respective values of cardiac output, left atrial pressure (pulmonary artery wedge pressure), right atrial pressure and blood pressure can be obtained with time (see FIG. 7), quantitatively as shown in FIG. It can be digitized and displayed continuously.
FIG. 9 is a diagram showing a cardiac output curve calculated according to the present invention, where (a) specifies the left atrial pressure and the right atrial pressure as axes, and (b) shows the left atrial pressure. When the cardiac output is defined on the axis, (c) shows the case where the right atrial pressure and the cardiac output are defined on the axis.
Thus, according to the present invention, diagnosis can be performed with extremely high accuracy, and even general physicians can easily perform visual diagnosis.

1 is a schematic configuration diagram of a heart disease diagnosis system according to the present invention. A schematic diagram of the heart is shown. An example of a cardiac output curve in a three-dimensional coordinate display of cardiac output, left atrial pressure, and right atrial pressure is shown. An example of the venous return plane in the three-dimensional coordinate display of cardiac output, left atrial pressure, and right atrial pressure is shown. An example of a cardiac output curve and a venous return plane in a three-dimensional coordinate display of cardiac output, left atrial pressure, and right atrial pressure is shown. The flowchart in the case of utilizing the heart disease diagnostic system which concerns on this invention is shown. Changes in hemodynamic abnormalities during myocardial infarction in dogs. The display result at the time of using the heart disease diagnostic system based on this invention in the case of FIG. 7 is shown. FIG. 7 shows a cardiac output curve when the heart disease diagnosis system according to the present invention is used in the case of FIG. 7, wherein (a) shows the case where the left atrial pressure and the right atrial pressure are defined as axes; Indicates the case where the left atrial pressure and the cardiac output are defined on the axis, and (c) indicates the case where the right atrial pressure and the cardiac output are defined on the axis.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Heart disease diagnosis system 2 ... Input means 31 ... 1st calculation means 32 ... 2nd calculation means 33 ... 3rd calculation means 4 ... Display means

Claims (10)

An input means 2 for inputting a patient's cardiac output value, a left atrial pressure value and / or a right atrial pressure value;
First calculation means 31 for calculating a left heart function value or a right heart function value from the inputted cardiac output value and the left atrial pressure value or the right atrial pressure value;
A cardiac disease diagnosis system comprising display means 4 for displaying a left heart function value and / or a right heart function value calculated by the first calculation means 31. The first calculation means 31 uses (Expression 1) and / or (Expression 2) from the cardiac output value input from the input means 2 and the left atrial pressure value and / or the right atrial pressure value. The heart disease diagnosis system according to claim 1, wherein the left heart function value and / or the right heart function value is calculated.

An input means 2 for inputting a patient's cardiac output value, left atrial pressure value and right atrial pressure value;
Second calculating means 32 for calculating an effective circulating blood volume value from the inputted cardiac output value, left atrial pressure value and right atrial pressure value;
A heart disease diagnosis system comprising display means 4 for displaying an effective circulating blood volume value calculated by the second calculation means 32. The second calculating means 32 calculates the effective circulatory blood volume value from the cardiac output value input from the input means 2, the left atrial pressure value, and the right atrial pressure value using (Equation 3). The heart disease diagnosis system according to claim 3, wherein:

Input means 2 for inputting a patient's cardiac output value, right atrial pressure value and blood pressure value;
Third calculation means 33 for calculating a vascular resistance value from the inputted cardiac output value, right atrial pressure value and blood pressure value;
A heart disease diagnosis system comprising display means 4 for displaying a vascular resistance value calculated by the third calculation means 33. The third calculating means 33 calculates the vascular resistance value by using (Expression 4) from the cardiac output value, the right atrial pressure value and the blood pressure value inputted from the input means 2. The heart disease diagnosis system according to claim 5.

  A system for diagnosing heart disease, characterized in that two or three of the systems 1 described in claim 1, claim 3 and claim 5 are combined.   The heart disease diagnosis system according to any one of claims 1 to 6, wherein the display means (4) displays each numerical value calculated from each of the calculation means (31, 32, 33) continuously in time series. .   9. The cardiac disease diagnosis system according to claim 1, wherein the cardiac output is measured by Swan-Ganz = catheter or calculated from an diastolic time constant of an arterial blood pressure waveform.   The left atrial pressure value is directly measured by a catheter, or is calculated by continuously estimating from the diastolic pressure value of pulmonary artery wedge pressure or pulmonary artery pressure by Swan-Ganz = catheter. The heart disease diagnosis system according to any one of 1 to 8.

Images