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Kokyu to Junkan Volume 47, Issue 3 （March 1999）

呼吸と循環 47巻3号（1999年3月発行）

Japanese English

研究

無侵襲冠動脈狭窄診断装置の臨床評価 Clinical Evaluation of Noninvasive Laser Diode Phonocardiometer for Detection of Coronary Artery Stenoses 松本博志 ¹ , 尾崎亘彦 ¹ , 岸卓人 ¹ , 岩本健吾 ¹ , 千葉真 ¹ , 満渕邦彦 ² , 柳生邦良 ³ Hiroshi Matsumoto ¹ , Norihiko Ozaki ¹ , Takuto Kishi ¹ , Kengo Iwamoto ¹ , Makoto Chiba ¹ , Kunihiko Mabuchi ² , Kuniyoshi Yagyu ³ ¹東京大学大学院工学系研究科精密機械工学専攻 ²東京大学国際産学共同研究センター ³日赤医療センター心臓血管外科 ¹Department of Precision Machinery Engineering Graduate School of Engineering, The University of Tokyo ²Center for Collaborative Research University of Tokyo ³Division of Cardiovascular Surgery, Japanese Red Cross Medical Center キーワード：半導体パルスレーザ , 冠動脈狭窄雑音 , スペクトルパワー密度 , laser diode , diastolic heart sounds , spectral power Keyword: 半導体パルスレーザ , 冠動脈狭窄雑音 , スペクトルパワー密度 , laser diode , diastolic heart sounds , spectral power pp.289-294

発行日 1999年3月15日 Published Date 1999/3/15

DOI https://doi.org/10.11477/mf.1404901866

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Abstract 文献概要
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　半導体パルスレーザを冠動脈狭窄雑音検出媒体とした無侵襲冠動脈狭窄診断装置を開発し臨床的評価を加えた．狭窄雑音が発生しない完全閉塞と狭窄部位を特定できないものの冠動脈狭窄雑音は特定でき，狭窄病変部位数の増加は雑音周波数の変位パワースペクトル密度の増大と広帯域化に符合し，狭窄程度は狭窄雑音の高周波域化に対応することが判明した．本装置は冠動脈疾患の診断，治療効果の判定には極めて有用である．加えて早期病変の診断にも貢献するものと考えられる．

Background : It has been reported that coronary stenoses produce sounds due to the turbulent blood flow in the partially occluded coronary arteries. These sounds were detected and analyzed using an appropriate signal processing approach. We developed a new system for noninvasive acoustical detection, which was made up of the newly-developed non contact laser diodephonocardiometer coupled with signal processing of maximum entropy method (MEM).

Methods : We evaluated our detecting system for subjects before and after bypass surgery as well as subjects in whom no bypass surgery had been perfor-med. Patients were selected from those undergoing CAG and/or surgery at the Japanese Red Cross Medical Center. Diastolic heart sounds were recorded for about 10 beats (10 sec) at the bedside and then analyzed by a personal computer. Full examination time was 10 min-utes per a patient.

Results : Clinical evaluation proved that the system detected the stenoses of coronary arteries. Results showed that diastolic heart sounds of patients with three or inure stenoses contained high spectral powers between 300 Hz and 1,000 Hz which were not observed in healthy subjects. A striking difference was observed in spectral characteristics before and after surgery. The number of the high spectral power columm was an indicator of the stenotic site. The high spectral power levels disappeared markedly by recovery of coronary blood flow following surgery. The findings were consis-tent with the coronary angiographic changes following bypass surgery.

Conclusion : the noninvasive laser diode phonocar-diometer system for detection of coronary stenoses was found to be an effective method not only for separating normals from abnormals but also for assessing the number of stenoses associated with coronary artery disease. In addition, it was able to be carried out speed-ily and at a low cost, and was able to be used instead of coronary angiography.