Ioannou Christos V, Morel Denis R, Katsamouris Asterios N, Katranitsa Sofia, Startchik Irena, Kalangos Afksentios, Westerhof Nico, Stergiopulos Nikos
Division of Vascular Surgery, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Greece.
J Vasc Res. 2009;46(5):417-25. doi: 10.1159/000194272. Epub 2009 Jan 21.
It was the aim of this study to investigate the long- term effects of reduced aortic compliance on cardiovascular hemodynamics and cardiac remodeling.
Sixteen swine, divided into 2 groups, a control and a banding group, were instrumented for pressure and flow measurement in the ascending aorta. Teflon prosthesis was wrapped around the aortic arch in order to limit wall compliance in the banding group. Hemodynamic parameters were recorded throughout a 60-day period. After sacrifice, the mean cell surface of the left ventricle was documented.
Banding decreased aortic compliance by 49 +/- 9, 44 +/- 16 and 42 +/- 7% on the 2nd, 30th and 60th postoperative day, respectively (p < 0.05), while systolic pressure increased by 41 +/- 11, 30 +/- 11 and 35 +/- 12% (p < 0.05), and pulse pressure by 86 +/- 27, 76 +/- 21 and 88 +/- 23%, respectively (p < 0.01). Aortic characteristic impedance increased significantly in the banding group. Diastolic pressure, cardiac output and peripheral resistance remained unaltered. The mean left ventricular cell surface area increased significantly in the banding group.
Acute reduction in aortic compliance results in a significant increase in characteristic and input impedance, a significant decrease in systemic arterial compliance and a subsequent increase in systolic and pulse pressures leading to left ventricular hypertrophy.
本研究旨在探讨主动脉顺应性降低对心血管血流动力学和心脏重塑的长期影响。
将16头猪分为两组,即对照组和结扎组,在升主动脉处安装压力和流量测量装置。在结扎组中,用特氟龙假体包裹主动脉弓以限制血管壁顺应性。在60天的时间内记录血流动力学参数。处死后,记录左心室的平均细胞表面积。
在术后第2天、第30天和第60天,结扎分别使主动脉顺应性降低49±9%、44±16%和42±7%(p<0.05),而收缩压分别升高41±11%、30±11%和35±12%(p<0.05),脉压分别升高86±27%、76±21%和88±23%(p<0.01)。结扎组的主动脉特性阻抗显著增加。舒张压、心输出量和外周阻力保持不变。结扎组的左心室平均细胞表面积显著增加。
主动脉顺应性的急性降低导致特性阻抗和输入阻抗显著增加,全身动脉顺应性显著降低,随后收缩压和脉压升高,导致左心室肥厚。