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总动脉顺应性和外周阻力在确定主动脉收缩压和舒张压中的作用。

Role of total arterial compliance and peripheral resistance in the determination of systolic and diastolic aortic pressure.

作者信息

Stergiopulos N, Westerhof N

机构信息

Biomedical Engineering Laboratory, Swiss Federal Institute of Technology, Lausanne, Switzerland.

出版信息

Pathol Biol (Paris). 1999 Jun;47(6):641-7.

Abstract

The goal of the study was to define the major arterial parameters that determine aortic systolic (Ps) and diastolic (Pd) pressure in the dog. Measured aortic flows were used as input to the two-element windkessel model of the arterial system, with peripheral resistance calculated as mean pressure over mean flow and total arterial compliance calculated from the decay time in diastole. The windkessel model yielded an aortic pressure wave from which we obtained the predicted systolic (Ps, wk) and diastolic (Pd, wk) pressure. These predicted pressures were compared with the measured systolic and diastolic pressures. The measurements and calculations were carried out in 7 dogs in control conditions, during aortic occlusion at four locations (the trifurcation, between trifurcation and diaphragm, the diaphragm and the proximal descending thoracic aorta) and during occlusion of both carotid arteries. Under all conditions studied the predicted systolic and diastolic pressure matched the experimental ones very well: Ps, wk = (1.000 +/- 0.0055) Ps with r = 0.958 and Pd, wk = (1.024 +/- 0.0035) Pd with r = 0.995. Linear regression for pulse pressure gave PPwk = (0.99 +/- 0.016) PP (r = 0.911). We found the accuracy of prediction equally good under control conditions and in presence of aortic or carotid artery occlusions. Multiple regression between pulse pressure and arterial resistance and total arterial compliance yielded a poor regression constant (r2 = 0.19) suggesting that the two arterial parameters alone cannot explain pulse pressure and that flow is an important determinant as well. We conclude that, for a given ejection pattern (aortic flow), two arterial parameters, total arterial resistance and total arterial compliance are sufficient to accurately describe systolic and diastolic aortic pressure.

摘要

本研究的目的是确定决定犬主动脉收缩压(Ps)和舒张压(Pd)的主要动脉参数。将测量得到的主动脉血流作为动脉系统双元件风箱模型的输入,外周阻力通过平均压力除以平均血流来计算,总动脉顺应性则根据舒张期的衰减时间来计算。风箱模型产生了一个主动脉压力波,从中我们获得了预测的收缩压(Ps, wk)和舒张压(Pd, wk)。将这些预测压力与测量得到的收缩压和舒张压进行比较。测量和计算在7只处于对照状态的犬身上进行,在主动脉四个位置(三叉处、三叉处与膈肌之间、膈肌与胸主动脉近端降段之间)进行主动脉阻断时以及双侧颈动脉阻断时进行。在所有研究条件下,预测的收缩压和舒张压与实验值匹配得非常好:Ps, wk = (1.000 ± 0.0055) Ps,r = 0.958;Pd, wk = (1.024 ± 0.0035) Pd,r = 0.995。脉压的线性回归得到PPwk = (0.99 ± 0.016) PP(r = 0.911)。我们发现,在对照条件下以及存在主动脉或颈动脉阻断时,预测的准确性同样良好。脉压与动脉阻力和总动脉顺应性之间的多元回归得到的回归常数较差(r2 = 0.19),这表明仅这两个动脉参数无法解释脉压,血流也是一个重要的决定因素。我们得出结论,对于给定的射血模式(主动脉血流),两个动脉参数,即总动脉阻力和总动脉顺应性,足以准确描述主动脉收缩压和舒张压。

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