Chemla Denis, Antony Isabelle, Zamani Karen, Nitenberg Alain
Service de Physiologie Cardio-Respiratoires, Université de Paris Sud 11, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin-Bicêtre, France.
J Appl Physiol (1985). 2005 Dec;99(6):2278-84. doi: 10.1152/japplphysiol.00713.2005. Epub 2005 Jul 28.
The aim of our study was twofold: 1) to establish a mathematical link between mean aortic pressure (MAP) and systolic (SAP) and diastolic aortic pressures (DAP) by testing the hypothesis that either the geometric mean or the harmonic mean of SAP and DAP were reliable MAP estimates; and 2) to critically evaluate three empirical formulas recently proposed to estimate MAP. High-fidelity pressures were recorded at rest at the aortic root level in controls (n = 31) and in subjects with various forms of cardiovascular diseases (n = 108). The time-averaged MAP and the pulse pressure (PP = SAP - DAP) were calculated. The MAP ranged from 66 to 160 mmHg [mean = 107.9 mmHg (SD 18.2)]. The geometric mean, i.e., the square root of the product of SAP and DAP, furnished a reliable estimate of MAP [mean bias = 0.3 mmHg (SD 2.7)]. The harmonic mean was inaccurate. The following MAP formulas were also tested: DAP + 0.412 PP (Meaney E, Alva F, Meaney A, Alva J, and Webel R. Heart 84: 64, 2000), DAP + 0.33 PP + 5 mmHg [Chemla D, Hébert JL, Aptecar E, Mazoit JX, Zamani K, Frank R, Fontaine G, Nitenberg A, and Lecarpentier Y. Clin Sci (Lond) 103: 7-13, 2002], and DAP + [0.33 + (heart rate x 0.0012)] PP (Razminia M, Trivedi A, Molnar J, Elbzour M, Guerrero M, Salem Y, Ahmed A, Khosla S, Lubell DL. Catheter Cardiovasc Interv 63: 419-425, 2004). They all provided accurate and precise estimates of MAP [mean bias = -0.2 (SD 2.9), -0.3 (SD 2.7), and 0.1 mmHg (SD 2.9), respectively]. The implications of the geometric mean pressure strictly pertained to the central (not peripheral) level. It was demonstrated that the fractional systolic (SAP/MAP) and diastolic (DAP/MAP) pressures were reciprocal estimates of aortic pulsatility and that the SAP times DAP product matched the total peripheral resistance times cardiac power product. In conclusion, although the previously described thumb-rules applied, the "geometric MAP" appears more valuable as it established a simple mathematical link between the steady and pulsatile component of aortic pressure.
1）通过检验收缩期主动脉压（SAP）和舒张期主动脉压（DAP）的几何平均数或调和平均数是可靠的平均主动脉压（MAP）估计值这一假设，建立MAP与SAP和DAP之间的数学联系；2）严格评估最近提出的三个用于估计MAP的经验公式。在对照组（n = 31）和患有各种心血管疾病的受试者（n = 108）中，于静息状态下在主动脉根部水平记录高保真压力。计算时间平均MAP和脉压（PP = SAP - DAP）。MAP范围为66至160 mmHg [平均值 = 107.9 mmHg（标准差18.2）]。几何平均数，即SAP与DAP乘积的平方根，提供了可靠的MAP估计值[平均偏差 = 0.3 mmHg（标准差2.7）]。调和平均数不准确。还测试了以下MAP公式：DAP + 0.412 PP（Meaney E、Alva F、Meaney A、Alva J和Webel R。《心脏》84：64，2000），DAP + 0.33 PP + 5 mmHg [Chemla D、Hébert JL、Aptecar E、Mazoit JX、Zamani K、Frank R、Fontaine G、Nitenberg A和Lecarpentier Y。《临床科学（伦敦）》103：7 - 13，2002]，以及DAP + [0.33 +（心率×0.0012）] PP（Razminia M、Trivedi A、Molnar J、Elbzour M、Guerrero M、Salem Y、Ahmed A、Khosla S、Lubell DL。《导管心血管介入》63：419 - 425，2004）。它们都提供了准确且精确的MAP估计值[平均偏差分别为 -0.2（标准差2.9）、 -0.3（标准差2.7）和0.1 mmHg（标准差2.9）]。几何平均压力的意义严格适用于中心（而非外周）水平。结果表明，收缩期分数压（SAP/MAP）和舒张期分数压（DAP/MAP）是主动脉搏动性的相互估计值，且SAP乘以DAP的乘积与总外周阻力乘以心脏功率的乘积相匹配。总之，尽管应用了先前描述的经验法则，但“几何MAP”似乎更具价值，因为它在主动脉压力的稳定成分和搏动成分之间建立了简单的数学联系。
Zotero 插件