Carlsson Marcus, Cain Peter, Holmqvist Catarina, Stahlberg Freddy, Lundback Stig, Arheden Hakan
Department of Clinical Physiology, Lund University Hospital, Lund SE-22185, Sweden.
Am J Physiol Heart Circ Physiol. 2004 Jul;287(1):H243-50. doi: 10.1152/ajpheart.01125.2003. Epub 2004 Mar 11.
Variations in total heart volume (atria plus ventricles) during a cardiac cycle affect efficiency of cardiac pumping. The goals of this study were to confirm the presence, extent, and contributors of total heart volume variation during the cardiac cycle in healthy volunteers with the use of MRI. Eight healthy volunteers were examined by MRI at rest. Changes in total cardiac volume throughout the cardiac cycle were calculated using the following methods: 1) planimetry derived from gradient-echo cine images and 2) flow-sensitive sequences to quantify flow in all vessels leading to and from the heart. The maximum total heart volume diminished during systole by 8.2 +/- 0.8% (SEM, range 4.8-10.6%) measured by method 1 and 8.8 +/- 1.0% (SEM, range 5.6-11.8%) by method 2 with good agreement between the methods [difference according to Bland-Altman analysis -0.6% +/- 1.0% (SD), intraclass correlation coefficient = 0.999]. This decrease in volume is predominantly explained by variation at the midcardiac level at the widest diameter of the heart with a left-sided predominance. In the short axis of the heart, the change of slice volume was proportional to the end-diastolic slice volume. The present study has confirmed the presence of total heart volume variation that predominantly occurs in the region of atrioventricular plane movement and on the left side. The total heart volume variation may relate to the efficiency of energy use by the heart to minimize displacement of surrounding tissue while accounting for the energy required to draw blood into the atria during ventricular systole.
心动周期中全心(心房加心室)容积的变化会影响心脏泵血效率。本研究的目的是通过磁共振成像(MRI)来确认健康志愿者心动周期中全心容积变化的存在、程度及其影响因素。8名健康志愿者在静息状态下接受了MRI检查。采用以下方法计算心动周期中全心容积的变化:1)从梯度回波电影图像得出的面积测量法;2)血流敏感序列,用于量化进出心脏的所有血管中的血流。通过方法1测量,收缩期全心最大容积减少了8.2±0.8%(标准误,范围4.8 - 10.6%),通过方法2测量减少了8.8±1.0%(标准误,范围5.6 - 11.8%),两种方法之间一致性良好[根据Bland - Altman分析差异为-0.6%±1.0%(标准差),组内相关系数 = 0.999]。容积的这种减少主要是由于心脏最宽直径处心中部水平的变化,且左侧更为明显。在心脏短轴上,层面容积的变化与舒张末期层面容积成比例。本研究已证实存在全心容积变化,其主要发生在房室平面运动区域及左侧。全心容积变化可能与心脏能量利用效率有关,即在心室收缩期将血液吸入心房所需能量的情况下,尽量减少周围组织的移位。