Okamoto M, Tsubokura T, Morishita K, Nakagawa H, Yamagata T, Kawagoe T, Hondo T, Tsuchioka Y, Matsuura H, Kajiyama G
Department of Clinical Pathology, Hiroshima University School of Medicine, Japan.
J Clin Ultrasound. 1991 Sep;19(7):405-11. doi: 10.1002/jcu.1870190707.
The effects of volume loading on the left atrial preejection period (LAPEP) and left atrial ejection time (LAET) were examined in 24 patients with various heart diseases using pulsed Doppler echocardiography. In response to volume loading, the left atrial dimension before atrial contraction significantly increased from 30.6 mm +/- 5.8 mm to 32.4 mm +/- 5.4 mm and the change in the left atrial dimension during atrial contraction tended to increase. The peak velocity in the atrial contraction phase significantly increased from 58 cm/s +/- 14 cm/s to 63 cm/s +/- 13 cm/s, and the integral of the atrial contraction phase tended to increase. LAPEP significantly decreased from 114 ms +/- 16 ms to 104 ms +/- 14 ms and LAET significantly decreased from 128 ms +/- 15 ms to 124 +/- 12 ms. The relation between LAET and left ventricular end-diastolic pressure, and that between LAPEP and mean pulmonary capillary wedge pressure, shifted downward to the right after volume loading. Thus, left atrial ejection is augmented by volume loading according to the Frank-Starling mechanism, while LAPEP decreases due to an increase in preload and LAET decreases due to an increase in afterload.
使用脉冲多普勒超声心动图，对24例患有各种心脏病的患者进行了容量负荷对左心房预射血期（LAPEP）和左心房射血时间（LAET）影响的研究。在容量负荷反应中，心房收缩前的左心房内径从30.6mm±5.8mm显著增加至32.4mm±5.4mm，且心房收缩期间左心房内径的变化有增加趋势。心房收缩期的峰值速度从58cm/s±14cm/s显著增加至63cm/s±13cm/s，且心房收缩期的积分有增加趋势。LAPEP从114ms±16ms显著降低至104ms±14ms，LAET从128ms±15ms显著降低至124±12ms。容量负荷后，LAET与左心室舒张末期压力之间的关系以及LAPEP与平均肺毛细血管楔压之间的关系向右下方移位。因此，根据Frank-Starling机制，容量负荷可增强左心房射血，而LAPEP因前负荷增加而降低，LAET因后负荷增加而降低。
