Evlakhov V I, Poiasov I Z, Tkachenko B I
Ross Fiziol Zh Im I M Sechenova. 2004 Jun;90(6):719-27.
Changes of the right atrial pressure, superior and inferior vena cava flows, right ventricular myocardial contractility (first derivate of right ventricular pressure, dP/dt max) following i.v. injection of acetylcholine, histamine and isoproterenol, were studied in acute experiments on anaesthetized mongrel cats with artificial lung ventilation and opened chest. The right atrial pressure in those cases could be increased (I group of animals) or decreased (II group). In maximal shifts of right atrial pressure following acetylcholine injection, the superior vena cava flow increased but the inferior vena cava flow decreased in equal proportion. When the right ventricular myocardial contractility decreased more than the right atrial pressure was augmented, and when the cardiac negative inotropic effect was weak, the right atrial pressure was reduced. After histamine injection in both groups of animals, right ventricular myocardial contractility was increased on the same level, and changes of the inferior vena cava flow were insignificant. The right atrial pressure was elevated following greater increase of superior vena cava flow. Isoproterenol caused the positive cardiac inotropic effect and augmenting of the superior vena cava flow in both groups of animals. The right atrial pressure was elevated if the inferior vena cava flow increased and, on the other hand, when the inferior vena cava flow decreased the right atrial pressure was reduced. Thus different maximal changes of the right atrial pressure following i.v. injection of acetylcholine, histamine and isoproterenol could be explained by different hemodynamic mechanisms of the interaction between superior and inferior vena cava flow shifts and changes of the right ventricular myocardial contractility.
在人工肺通气并开胸的麻醉杂种猫急性实验中,研究了静脉注射乙酰胆碱、组胺和异丙肾上腺素后右心房压力、上腔静脉和下腔静脉血流、右心室心肌收缩力(右心室压力的一阶导数,dP/dt max)的变化。在这些情况下,右心房压力可能升高(I组动物)或降低(II组)。在注射乙酰胆碱后右心房压力出现最大变化时,上腔静脉血流增加,而下腔静脉血流以相同比例减少。当右心室心肌收缩力下降幅度超过右心房压力升高幅度,且心脏负性肌力作用较弱时,右心房压力降低。在两组动物注射组胺后,右心室心肌收缩力在相同水平上增加,下腔静脉血流变化不明显。当上腔静脉血流增加幅度更大时,右心房压力升高。异丙肾上腺素在两组动物中均引起心脏正性肌力作用并增加上腔静脉血流。如果下腔静脉血流增加,右心房压力升高,另一方面,当下腔静脉血流减少时,右心房压力降低。因此,静脉注射乙酰胆碱、组胺和异丙肾上腺素后右心房压力的不同最大变化可以通过上腔静脉和下腔静脉血流变化与右心室心肌收缩力之间相互作用的不同血流动力学机制来解释。