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急性心肌抑制对左心室僵硬度及其弹性和粘性成分的影响。

Influence of acute myocardial depression on left ventricular stiffness and its elastic and viscous components.

作者信息

Templeton G H, Wildenthal K, Willerson J T, Mitchell J H

出版信息

J Clin Invest. 1975 Aug;56(2):278-85. doi: 10.1172/JCI108091.

Abstract

The influence of acute myocardial depression on ventricular stiffness and on its elastic and viscous components was studied in 19 dogs. After the animals were placed on cardiopulmonary bypass, stiffness was measured by sinusoidally injecting volume changes of 0.5 ml (deltaV) at 22 Hz into paced, isovolumically (deltaP) of the sinusoidal pressure response. Stiffness was linearly related to pressure (P) throughout the cardiac cycle, so that deltaP/delta V = alpha P + beta, where alpha and beta are constants. Myocardial depression was induced in one of three different ways: by coronary artery ligation, by administration of propranolol (Inderal), or by administration of pentobarbital. All three interventions caused significant increases in the slope, alpha, of the stiffness-pressure relationship, while the intercept, beta, remained unchanged. Release of the coronary occlusion or administration of acetylstrophantidin partially reversed depression and the change in alpha; Approximation of the mechanical nature of the left ventricle in terms of a linear second-order mechanical system permitted the division of stiffness into its elastic and viscous components. Like total stiffness, both the elastic and the viscous components were linearly related to ventricular pressure. Elastic stiffness was not changed, but the slope of the line relating viscous stiffness to pressure was significantly increased during ischemic depression, indicating that a change in viscosity was primarily responsible for the increase in total ventricular stiffness.

摘要

在19只狗身上研究了急性心肌抑制对心室僵硬度及其弹性和粘性成分的影响。将动物置于体外循环后,通过以22Hz的频率向起搏的等容心室中正弦注入0.5ml的容积变化(ΔV),并测量正弦压力响应的(ΔP)来测定僵硬度。在整个心动周期中,僵硬度与压力(P)呈线性相关,即ΔP/ΔV =αP +β,其中α和β为常数。通过三种不同方式之一诱导心肌抑制:冠状动脉结扎、给予普萘洛尔(心得安)或给予戊巴比妥。所有这三种干预措施均导致僵硬度 - 压力关系的斜率α显著增加,而截距β保持不变。解除冠状动脉阻塞或给予乙酰洋地黄毒苷可部分逆转抑制和α的变化;根据线性二阶力学系统来近似左心室的力学性质,可以将僵硬度分为其弹性和粘性成分。与总僵硬度一样,弹性和粘性成分均与心室压力呈线性相关。弹性僵硬度未改变,但在缺血性抑制期间,粘性僵硬度与压力关系线的斜率显著增加,表明粘度变化是心室总僵硬度增加的主要原因。

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