Piene H, Myhre E S
Department of Biomedical Engineering, Faculty of Medicine, University Hospital, Trondheim, Norway.
Am J Physiol. 1991 Jan;260(1 Pt 2):H158-64. doi: 10.1152/ajpheart.1991.260.1.H158.
The impact of the transseptal pressure gradient (TSP) during the entire heart cycle has not been assessed. This study explores in anesthetized open-chest dogs the interventricular septum's relative position to the anteroposterior transverse diameter (Dap) of the left ventricle (LV). By varying preload and afterload for both LV and right ventricle (RV) and inotropy in LV, a wide range of TSP was generated. By ultrasonomicrometry the distance between the Dap and the midpoint of septum was recorded. 1) Loops of the septal-LV free-wall diameter vs. Dap showed that the LV transverse cross section independent of loading conditions tended to reach a circular form during systole. 2) Paradoxical movement of the intraventricular septum occurred when TSP was less than zero but was not dependent on an increase of TSP. 3) TSP's influence on septum's position was reduced to one-tenth when changing from end diastole to end systole. 4) During systole independent of level of LV performance, LV pressure had approximately 50% less influence on septal position than RV pressure. 5) During depressed LV performance a similar pattern was evident during diastole. 6) The pericardium had no influence on septum's position. This study demonstrates that the position of the intraventricular septum is significantly influenced by the time-varying elastance of LV and the septum itself, and that RV pressure changes have a greater impact on septal position than LV pressure changes.
尚未评估整个心动周期中跨间隔压力梯度(TSP)的影响。本研究在麻醉开胸犬中探究了室间隔相对于左心室(LV)前后横径(Dap)的相对位置。通过改变左心室和右心室(RV)的前负荷、后负荷以及左心室的心肌收缩力,产生了广泛的TSP范围。通过超声测微法记录Dap与室间隔中点之间的距离。1)室间隔 - 左心室游离壁直径与Dap的环显示,在收缩期,与负荷条件无关的左心室横切面倾向于呈圆形。2)当TSP小于零时,室内隔出现矛盾运动,但这并不依赖于TSP的增加。3)从舒张末期到收缩末期,TSP对室间隔位置的影响降低至十分之一。4)在收缩期,与左心室功能水平无关,左心室压力对室间隔位置的影响比右心室压力小约50%。5)在左心室功能降低时,舒张期也有类似的模式。6)心包对室间隔位置没有影响。本研究表明,室内隔的位置受左心室和室间隔本身随时间变化的弹性显著影响,并且右心室压力变化对室间隔位置的影响大于左心室压力变化。