Yuan Lijun, Cao Tiesheng, Duan Yunyou, Yang Guodong, Wang Zuojun, Ruan Litao
Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, People's Republic of China.
Echocardiography. 2004 Jul;21(5):391-8. doi: 10.1111/j.0742-2822.2004.03086.x.
The aim of our study is to quantitatively investigate influence of the intrathoracic pressure change on the four cardiac valves' velocities and further verify a new proposal of the mechanism of respiratory influence on hemodynamics.
Thirty healthy volunteers with no cardiopulmonary diseases were included. The intrathoracic pressure changes were measured with self-designed device. The velocity across the four cardiac valves during spontaneous respiration and with the intrathoracic pressure change at -4, -8, and -12 mmHg, respectively, were recorded simultaneously with the electrocardiogram and respiratory curve. The respiratory variation indices (RVIs) were calculated. The average RVIs of mitral, aortic, tricuspid, and pulmonary valves were 12.54%, 13.19%; 6.23%, 8.27%; 20.27%, 24.36%; and 6.45%, 7.69% with intrathoracic pressure change at -8 mmHg and -12 mmHg, respectively. All the above parameters have a significant difference from those during spontaneous respiration (P < 0.01 or P < 0.001). We concluded that it might be the respiratory intrathoracic pressure change that causes the change of the velocity across the valves.
我们研究的目的是定量研究胸内压变化对四个心脏瓣膜速度的影响,并进一步验证关于呼吸对血流动力学影响机制的新提议。
纳入30名无心肺疾病的健康志愿者。使用自行设计的装置测量胸内压变化。在自发呼吸过程中以及胸内压分别为-4、-8和-12 mmHg变化时,同时记录四个心脏瓣膜的速度以及心电图和呼吸曲线。计算呼吸变化指数(RVIs)。在胸内压为-8 mmHg和-12 mmHg时,二尖瓣、主动脉瓣、三尖瓣和肺动脉瓣的平均RVIs分别为12.54%、13.19%;6.23%、8.27%;20.27%、24.36%;以及6.45%、7.69%。上述所有参数与自发呼吸时相比均有显著差异(P < 0.01或P < 0.001)。我们得出结论,可能是呼吸性胸内压变化导致了瓣膜速度的改变。