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等容舒张期作为不同后负荷条件下左心室舒张的指标——与犬左心室压力衰减时间常数的比较

Isovolumic relaxation period as an index of left ventricular relaxation under different afterload conditions--comparison with the time constant of left ventricular pressure decay in the dog.

作者信息

Ochi H, Ikuma I, Toda H, Shimada T, Morioka S, Moriyama K

机构信息

Fourth Department of Internal Medicine, Shimane Medical University, Izumo, Japan.

出版信息

Jpn Circ J. 1989 Dec;53(12):1521-9. doi: 10.1253/jcj.53.1521.

Abstract

In order to determine whether isovolumic relaxation period (IRP) reflects left ventricular relaxation under different afterload conditions, 17 anesthetized, open chest dogs were studied, and the left ventricular pressure decay time constant (T) was calculated. In 12 dogs, angiotensin II and nitroprusside were administered, with the heart rate constant at 90 beats/min. Multiple linear regression analysis showed that the aortic dicrotic notch pressure (AoDNP) and T were major determinants of IRP, while left ventricular end-diastolic pressure was a minor determinant. Multiple linear regression analysis, correlating T with IRP and AoDNP, did not further improve the correlation coefficient compared with that between T and IRP. We concluded that correction of the IRP by AoDNP is not necessary to predict T from additional multiple linear regression. The effects of ascending aortic constriction or angiotensin II on IRP were examined in five dogs, after pretreatment with propranolol. Aortic constriction caused a significant decrease in IRP and T, while angiotensin II produced a significant increase in IRP and T. IRP was affected by the change of afterload. However, the IRP and T values were always altered in the same direction. These results demonstrate that IRP is substituted for T and it reflects left ventricular relaxation even in different afterload conditions. We conclude that IRP is a simple parameter easily used to evaluate left ventricular relaxation in clinical situations.

摘要

为了确定等容舒张期(IRP)是否能反映不同后负荷条件下的左心室舒张功能,对17只麻醉开胸犬进行了研究,并计算了左心室压力衰减时间常数(T)。在12只犬中,静脉注射血管紧张素II和硝普钠,心率维持在90次/分钟。多元线性回归分析显示,主动脉重搏切迹压力(AoDNP)和T是IRP的主要决定因素,而左心室舒张末期压力是次要决定因素。将T与IRP和AoDNP进行多元线性回归分析,与T和IRP之间的相关性相比,相关系数并未进一步提高。我们得出结论,从额外的多元线性回归中预测T时,无需用AoDNP校正IRP。在5只经普萘洛尔预处理的犬中,研究了升主动脉缩窄或血管紧张素II对IRP的影响。主动脉缩窄导致IRP和T显著降低,而血管紧张素II使IRP和T显著升高。IRP受后负荷变化的影响。然而,IRP和T值总是朝相同方向改变。这些结果表明,IRP可替代T,即使在不同后负荷条件下,它也能反映左心室舒张功能。我们得出结论,IRP是一个简单的参数,易于在临床情况下用于评估左心室舒张功能。

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