Matsuda Y, Toma Y, Matsuzaki M, Moritani K, Satoh A, Shiomi K, Ohtani N, Kohno M, Fujii T, Katayama K
Department of Internal Medicine, Yamaguchi University School of Medicine, Japan.
Circulation. 1990 Nov;82(5):1659-67. doi: 10.1161/01.cir.82.5.1659.
The relation between the left atrial systolic pressure waveform and left ventricular end-diastolic pressure was observed in 17 patients who underwent diagnostic cardiac catheterization. Left atrial pressure and left ventricular pressure were simultaneously recorded from a multisensor catheter before and during angiotensin infusion. Left ventricular systolic pressure and left ventricular end-diastolic pressure were 133 +/- 17 and 12.3 +/- 3.2 mm Hg, respectively, before angiotensin infusion and increased to 168 +/- 18 (p less than 0.01) and 19.4 +/- 4.5 mm Hg (p less than 0.01), respectively, during infusion. The left atrial systolic pressure curve consisted of two positive waves--a first wave (A) and a second wave (A'). The A and A' wave pressures were 11.6 +/- 2.3 and 10.2 +/- 3.9 mm Hg, respectively, before angiotensin infusion and 16.5 +/- 2.9 (p less than 0.01) and 18.1 +/- 4.7 mm Hg (p less than 0.01), respectively, during infusion. The ratio of A'/A of left atrial systolic pressure was 0.81 +/- 0.27 before angiotensin infusion and 1.08 +/- 0.14 (p less than 0.01) during infusion. The ratio of A' to A of left atrial systolic pressure was linearly related to left ventricular end-diastolic pressure before and during (p less than 0.01) angiotensin infusion. The amplitude of the A wave exceeded that of the A' wave at normal left ventricular end-diastolic pressures. However, as the left ventricular end-diastolic pressure increased either at rest or during angiotensin infusion, the amplitude of the A' wave increased and often exceeded that of the A wave. These results suggest that the second (A') wave might be attributed to the increased reflection associated with increased left ventricular end-diastolic pressure.
对17例接受诊断性心导管插入术的患者观察了左心房收缩压波形与左心室舒张末期压力之间的关系。在输注血管紧张素之前和期间，使用多传感器导管同时记录左心房压力和左心室压力。输注血管紧张素之前，左心室收缩压和左心室舒张末期压力分别为133±17和12.3±3.2 mmHg，输注期间分别升高至168±18（p<0.01）和19.4±4.5 mmHg（p<0.01）。左心房收缩压曲线由两个正向波组成——第一个波（A波）和第二个波（A'波）。输注血管紧张素之前，A波和A'波压力分别为11.6±2.3和10.2±3.9 mmHg，输注期间分别为16.5±2.9（p<0.01）和18.1±4.7 mmHg（p<0.01）。左心房收缩压的A'/A比值在输注血管紧张素之前为0.81±0.27，输注期间为1.08±0.14（p<0.01）。在输注血管紧张素之前和期间（p<0.01），左心房收缩压的A'与A的比值与左心室舒张末期压力呈线性相关。在正常左心室舒张末期压力时，A波的幅度超过A'波。然而，随着左心室舒张末期压力在静息时或输注血管紧张素期间升高，A'波的幅度增加，且常常超过A波。这些结果表明，第二个（A'）波可能归因于与左心室舒张末期压力升高相关的反射增加。
