McCulloch A D, Hunter P J, Smaill B H
Department of Physiology, University of Auckland, New Zealand.
Am J Physiol. 1992 Feb;262(2 Pt 2):H523-30. doi: 10.1152/ajpheart.1992.262.2.H523.
Mechanical effects of coronary perfusion on passive left ventricular filling were studied in seven isolated potassium-arrested dog hearts subjected to static pressure loading. With the use of a biplane video method, midanterior epicardial deformations were measured before, during, and after perfusion of the coronary circulation with a cardioplegic solution. During perfusion, there was a highly significant reduction (P less than 0.001) in ventricular compliance; the mean cavity volume change decreased by 50% at a filling pressure of 12 mmHg. The loss of compliance was reversible and increased with coronary artery pressure. The magnitudes of the principal epicardial extensions, determined by homogeneous strain analysis, also decreased significantly (P less than 0.001) by an average of 30-40% at ventricular pressures of 4-12 mmHg. But there was no change in the pattern of epicardial deformations. These findings, and similar significant falls in epicardial in-plane rotation (P less than 0.05) and angular translation (P less than 0.001), suggest that the main mechanical effect of the coronary circulation is homogeneous and uniform and is, therefore, probably associated with the microcirculation. We propose that this effect may be modeled by treating the myocardium as a porous elastic medium swollen with an incompressible fluid rather than by an increase in ventricular wall thickness due to filling of the coronary vessels.
在七颗经钾停搏、承受静态压力负荷的离体犬心脏中,研究了冠状动脉灌注对左心室被动充盈的机械效应。使用双平面视频方法,在冠状动脉循环用心脏停搏液灌注前、灌注期间和灌注后测量心外膜中部变形。灌注期间,心室顺应性显著降低(P<0.001);在12 mmHg的充盈压力下,平均腔室容积变化减少了50%。顺应性的丧失是可逆的,且随冠状动脉压力增加。通过均匀应变分析确定的主要心外膜伸展幅度,在4-12 mmHg的心室压力下也显著降低(P<0.001),平均降低30%-40%。但心外膜变形模式没有变化。这些发现,以及心外膜平面内旋转(P<0.05)和角平移(P<0.001)的类似显著下降,表明冠状动脉循环的主要机械效应是均匀一致的,因此可能与微循环有关。我们提出,这种效应可以通过将心肌视为充满不可压缩流体的多孔弹性介质来建模,而不是通过冠状动脉血管充盈导致心室壁厚度增加来建模。