Burkhoff Daniel, Mirsky Israel, Suga Hiroyuki
Division of Cardiology, Dept. of Medicine, Columbia Univ., Black Bldg. 812, 650 West 168th St., New York, NY 10032, USA.
Am J Physiol Heart Circ Physiol. 2005 Aug;289(2):H501-12. doi: 10.1152/ajpheart.00138.2005.
Assessment of left ventricular systolic and diastolic pump properties is fundamental to advancing the understanding of cardiovascular pathophysiology and therapeutics, especially for heart failure. The use of end-systolic and end-diastolic pressure-volume relationships derived from measurements of instantaneous left ventricular pressure-volume loops emerged in the 1970s as a comprehensive approach for this purpose. As invasive and noninvasive techniques for measuring ventricular volume improved over the past decades, these relations have become commonly used by basic, translational, and clinical researchers. This review summarizes 1) the basic concepts underlying pressure-volume analysis of ventricular and myocardial systolic and diastolic properties, 2) deviations from ideal conditions typically encountered in real-life applications, 3) how these relationships are appropriately analyzed, including statistical analyses, and 4) the most common problems encountered by investigators and the appropriate remedies. The goal is to provide practical information and simple guidelines for accurate application and interpretation of pressure-volume data as they pertain to characterization of ventricular and myocardial properties in health and disease.
评估左心室收缩和舒张泵功能对于深化对心血管病理生理学和治疗学的理解至关重要,尤其是对于心力衰竭而言。利用从瞬时左心室压力-容积环测量得出的收缩末期和舒张末期压力-容积关系,在20世纪70年代作为实现这一目的的综合方法应运而生。随着过去几十年间测量心室容积的侵入性和非侵入性技术不断改进,这些关系已被基础、转化和临床研究人员广泛应用。本综述总结了:1)心室和心肌收缩与舒张特性压力-容积分析的基本概念;2)实际应用中通常遇到的与理想条件的偏差;3)如何对这些关系进行恰当分析,包括统计分析;4)研究人员遇到的最常见问题及合适的补救措施。目的是提供实用信息和简单指南,以便准确应用和解读与健康和疾病状态下心室及心肌特性表征相关的压力-容积数据。