Bombardini T, Gaggini G, Marcelli E, Parlapiano M, Plicchi G
Servizio di Tecnologie Biomediche Policlinico S. Orsola, Bologna, Italy.
Pacing Clin Electrophysiol. 2000 Sep;23(9):1381-5. doi: 10.1111/j.1540-8159.2000.tb00966.x.
Previous studies demonstrated that peak endocardial acceleration (PEA) in sinus rhythm is related to LV dP/dtmax. Until now, PEA was never evaluated during R-R interval variations in AF. The aim of this study was to establish the behavior of PEA in AF and the relationship of PEA versus LV dP/dtmax. Six sheep (65 +/- 6 kg) were instrumented with a LV Millar catheter and with an accelerometer lead. AF was induced and PEA, LV dP/dtmax, and ECG were monitored. AF persisted for 5 +/- 1.3 minutes. From sinus rhythm to AF, the heart rate went from 92 +/- 3 to 130 +/- 35 beats/min (P < 0.05), LV dP/dtmax from 684 +/- 18 to 956 +/- 344 mmHg/s (P = NS) and PEA from 0.82 +/- 0.06 to 0.94 +/- 0.33 g (P = NS). The correlation between PEA and LV dP/dtmax was significative in sinus rhythm (r = 0.7, P < 0.05) and in AF (r = 0.8, P < 0.05). A positive relationship was found between the preceding interval and PEA (r = 0.4 +/- 0.07, P < 0.05) and LV dP/dtmax (r = 0.61 +/- 0.08, P < 0.05), while a negative one was found between the prepreceding interval and both PEA (r = -0.39 +/- 0.11, P < 0.05) and LV dP/dtmax (r = -0.64 +/- 0.05, P < 0.05). At the onset of AF, LV dP/dtmax and PEA showed similar changes: beat-to-beat correlation between PEA and LV dP/dtmax was high. As for LV dP/dtmax, PEA is positively related to the preceding interval and negatively related to the prepreceding interval. These data confirm that PEA reflects heart contractility also during AF and hold promise for the use of this sensor in therapeutic implantable devices.
先前的研究表明，窦性心律时的峰值心内膜加速度（PEA）与左心室dp/dtmax有关。到目前为止，从未在房颤的R-R间期变化期间评估过PEA。本研究的目的是确定房颤时PEA的表现以及PEA与左心室dp/dtmax之间的关系。对6只绵羊（65±6千克）植入左心室Millar导管和加速度计导联。诱发房颤并监测PEA、左心室dp/dtmax和心电图。房颤持续5±1.3分钟。从窦性心律到房颤，心率从92±3次/分钟增至130±35次/分钟（P<0.05），左心室dp/dtmax从684±18mmHg/s增至956±344mmHg/s（P=无显著性差异），PEA从0.82±0.06g增至0.94±0.33g（P=无显著性差异）。在窦性心律（r=0.7，P<0.05）和房颤（r=0.8，P<0.05）时，PEA与左心室dp/dtmax之间的相关性具有显著性。在前一个间期与PEA（r=0.4±0.07，P<0.05）和左心室dp/dtmax（r=0.61±0.08，P<0.05）之间发现正相关，而在前前一个间期与PEA（r=-0.39±0.11，P<0.05）和左心室dp/dtmax（r=-0.64±0.05，P<0.05）之间发现负相关。在房颤发作时，左心室dp/dtmax和PEA表现出相似的变化：PEA与左心室dp/dtmax之间的逐搏相关性很高。至于左心室dp/dtmax，PEA与前一个间期呈正相关，与前前一个间期呈负相关。这些数据证实，PEA在房颤期间也反映心脏收缩力，并有望用于治疗性植入设备中的这种传感器。
