Slørdahl S A, Piene H
Department of Biomedical Engineering, University of Trondheim, Norway.
Cardiovasc Res. 1991 Oct;25(10):869-74. doi: 10.1093/cvr/25.10.869.
Afterload reduction is known to reduce regurgitant flow in patients with aortic regurgitation. Both arterial compliance and total peripheral resistance are determinants of afterload. The aim of this study was to evaluate the influence of arterial compliance and total peripheral resistance on the regurgitant volume.
The values of arterial compliance and total peripheral resistance were assessed during aortic regurgitation at different regurgitant orifice areas in eight pigs before and after a bolus of glyceryl trinitrate. In a computer model the importance of arterial compliance and total peripheral resistance on the regurgitant volume was assessed by keeping each of them constant while the other variable was changed.
In both the experimental and computer models a very strong correlation was found between decreased total peripheral resistance and decreased regurgitant volume. Arterial compliance was of hardly any importance. A bolus of glyceryl trinitrate reduced regurgitant volumes and regurgitant fractions significantly.
Total peripheral resistance is an important factor in influencing the regurgitant volumes at a given regurgitant orifice area in aortic regurgitation, while arterial compliance is of less importance. Glyceryl trinitrate effectively reduces the regurgitant volumes by its effect on peripheral resistance.
已知降低后负荷可减少主动脉瓣反流患者的反流流量。动脉顺应性和总外周阻力均为后负荷的决定因素。本研究旨在评估动脉顺应性和总外周阻力对反流容积的影响。
在8只猪的主动脉瓣反流过程中，于不同反流口面积时，在静脉推注硝酸甘油前后评估动脉顺应性和总外周阻力值。在计算机模型中，通过保持其中一个因素不变而改变另一个变量，评估动脉顺应性和总外周阻力对反流容积的重要性。
在实验模型和计算机模型中，均发现总外周阻力降低与反流容积降低之间存在非常强的相关性。动脉顺应性几乎无重要影响。静脉推注硝酸甘油可显著降低反流容积和反流分数。
在给定的主动脉瓣反流口面积时，总外周阻力是影响反流容积的重要因素，而动脉顺应性的重要性较小。硝酸甘油通过其对外周阻力的作用有效降低反流容积。
