Chen Y T, Chen K S, Chen J S, Lin W W, Hu W H, Chang M K, Lee D Y, Lee Y S, Lin J R, Chiang B N
Division of Cardiology, Taichung Veterans General Hospital, National Yung-Ming Medical College, Chung Shan Medical and Dental College, Taiwan, Republic of China.
Jpn Heart J. 1990 Sep;31(5):619-29. doi: 10.1536/ihj.31.619.
The hydraulic load of the right and left ventricles and the clinical effects of nifedipine were evaluated in 8 normal subjects (mean age: 55 years) and 8 patients with cor pulmonale secondary to chronic obstructive lung disease (mean age: 57 years). It was found that there were differences in the right ventricular resistance (174.62 +/- 25.96 vs 468.57 +/- 178.81 dyne/sec/cm-5), first zero crossing frequency (3.62 +/- 0.34 vs 6.07 +/- 3.56 Hz), steady power (218.95 +/- 32.25 vs 359.44 +/- 37.46 mW) and total power of right ventricle (275.81 +/- 36.18 vs 440.46 +/- 85.16 mW) between the normal and cor pulmonale patients, respectively. However, no significant changes in characteristic impedance, pulsatile power or aortic impedance were observed in the right pulmonary artery. After administration of nifedipine to patients with cor pulmonale, there were significant changes in resistance (468.57 +/- 178.81 vs 256.36 +/- 178.56 dyne/sec/cm-5), steady power (359.44 +/- 37.46 vs 225.51 +/- 114.64) and total power (440.46 +/- 85.16 vs. 289.27 +/- 50.85) of the pulmonary artery, respectively. Otherwise there were no significant changes in aortic input impedance or characteristic impedance of right pulmonary artery and pulsatile power. In conclusion, we found that: 1) the hydraulic vascular load in the right ventricle was higher in patients with cor pulmonale, 2) characteristic impedance that was not increased in cor pulmonale patients may be due to a dilated pulmonary artery, 3) there was no impedance mismatch between left ventricle and systemic arterial system in patients with cor pulmonale, and 4) by reducing the pulmonary vascular resistance through nifedipine administration, the total external right ventricular power might be reduced, without affecting the proximal pulmonary arterial compliance.
在8名正常受试者(平均年龄:55岁)和8名慢性阻塞性肺疾病继发肺心病患者(平均年龄:57岁)中评估了左右心室的水力负荷以及硝苯地平的临床效果。结果发现,正常人和肺心病患者的右心室阻力(174.62±25.96对468.57±178.81达因/秒/厘米⁻⁵)、首次过零频率(3.62±0.34对6.07±3.56赫兹)、稳定功率(218.95±32.25对359.44±37.46毫瓦)和右心室总功率(275.81±36.18对440.46±85.16毫瓦)存在差异。然而,右肺动脉的特性阻抗、搏动功率或主动脉阻抗未观察到显著变化。对肺心病患者给予硝苯地平后,肺动脉的阻力(468.57±178.81对256.36±178.56达因/秒/厘米⁻⁵)、稳定功率(359.44±37.46对225.51±114.64)和总功率(440.46±85.16对289.27±50.85)分别有显著变化。此外,主动脉输入阻抗、右肺动脉特性阻抗和搏动功率无显著变化。总之,我们发现:1)肺心病患者右心室的水力血管负荷较高;2)肺心病患者特性阻抗未增加可能是由于肺动脉扩张;3)肺心病患者左心室与体动脉系统之间不存在阻抗不匹配;4)通过给予硝苯地平降低肺血管阻力,右心室总外部功率可能降低,而不影响近端肺动脉顺应性。