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健康受试者以及冠状动脉搭桥手术前后患者的容积中心和全心容积变化

Center of volume and total heart volume variation in healthy subjects and patients before and after coronary bypass surgery.

作者信息

Carlsson Marcus, Rosengren Anders, Ugander Martin, Ekelund Ulf, Cain Peter A, Arheden Hakan

机构信息

Department of Clinical Physiology, Lund University Hospital, Lund, Sweden.

出版信息

Clin Physiol Funct Imaging. 2005 Jul;25(4):226-33. doi: 10.1111/j.1475-097X.2005.00617.x.

Abstract

BACKGROUND

Total heart volume variation (THVV) and center of volume variation (COVV) likely affects the efficiency of cardiac pumping, but no study has determined COVV of the heart throughout the cardiac cycle or the effect of surgery on THVV in adults. Therefore, the purposes of this study were to determine COVV in healthy adults and patients with cardiac failure due to ischemic heart disease (IHD), identify any difference in THVV between these two groups, and determine how these parameters are affected by coronary bypass surgery.

METHODS

Six healthy volunteers and eight patients before and after surgery were investigated with cardiovascular magnetic resonance imaging. The atrioventricular plane movement (AVPM), THVV and time resolved three-dimensional coordinates of the center of the cardiac volume (COVV) were measured.

RESULTS

COVV followed a loop in 3D space that between the end-points was approximately 2 mm with no difference between healthy subjects and patients before surgery (P = 0.093), although AVPM was significantly lower in patients (P = 0.002). However, after surgery the COVV during the cardiac cycle doubled (P = 0.012) and the increase in THVV was significant (P = 0.050), although of very small magnitude, and the AVPM remained unchanged (P = 0.401).

CONCLUSION

COVV and THVV were similar in patients and healthy subjects even though AVPM was lower in the patient population. After surgery, however, COVV doubled despite a very small change in THVV and no change in AVPM. Taken together, the results of this study may provide new insights into the energy expenditure and efficiency of cardiac pumping.

摘要

背景

全心容积变化(THVV)和容积变化中心(COVV)可能会影响心脏泵血效率,但尚无研究确定整个心动周期中心脏的COVV或手术对成人心肌THVV的影响。因此,本研究的目的是确定健康成年人和缺血性心脏病(IHD)所致心力衰竭患者的COVV,识别这两组患者之间THVV的差异,并确定这些参数如何受到冠状动脉搭桥手术的影响。

方法

对6名健康志愿者以及8名手术前后的患者进行心血管磁共振成像检查。测量房室平面运动(AVPM)、THVV和心脏容积中心的时间分辨三维坐标(COVV)。

结果

COVV在三维空间中呈环状,两个端点之间约为2mm,健康受试者与术前患者之间无差异(P = 0.093),尽管患者的AVPM显著较低(P = 0.002)。然而,手术后心动周期中的COVV增加了一倍(P = 0.012),THVV的增加也很显著(P = 0.050),尽管幅度很小,且AVPM保持不变(P = 0.401)。

结论

尽管患者群体中的AVPM较低,但患者和健康受试者的COVV和THVV相似。然而,手术后,尽管THVV变化很小且AVPM没有变化,但COVV增加了一倍。综上所述,本研究结果可能为心脏泵血的能量消耗和效率提供新的见解。

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