Ferguson J J, Miller M J, Aroesty J M, Sahagian P, Grossman W, McKay R G
Charles A. Dana Research Institute, Beth Israel Hospital, Boston, Massachusetts.
J Am Coll Cardiol. 1989 Mar 1;13(3):630-6. doi: 10.1016/0735-1097(89)90604-9.
Assessment of the complex relations between pressure and volume in the right atrium has been hampered in the past by difficulties in the measurement of atrial volume. Accordingly, in the present study the dynamics of right atrial pressure-volume relations were examined (with the use of an impedance catheter to measure right atrial volume) in patients with and without an atrial septal defect. Right atrial pressure and impedance volume were measured in 16 patients at the time of cardiac catheterization with the use of a multi-electrode impedance catheter to provide continuous, on-line, pressure-volume data. Eleven patients without evidence of an interatrial shunt were examined during normal respiration and during the Valsalva maneuver and contrasted with five patients with an atrial septal defect documented by oxygen saturation step-up and echocardiographic studies. Right atrial pressure-volume diagrams in patients without an atrial septal defect exhibited the normal figure eight pattern, with an A loop (atrial contraction) and a V loop (passive filling), corresponding to the A wave and V wave of right atrial pressure, respectively. During inspiration, mean right atrial pressure decreased and mean right atrial volume increased, consistent with augmented venous return. With the Valsalva maneuver, right atrial pressure increased and both right atrial stroke volume and mean right atrial volume decreased compared with baseline. Patients with an atrial septal defect demonstrated baseline pressure-volume diagrams similar to those of patients without an interatrial shunt. However, no change in mean right atrial volume occurred with either respiration or the Valsalva maneuver despite changes in right atrial pressure similar to those seen inpatients without an atrial septal defect.(ABSTRACT TRUNCATED AT 250 WORDS)
过去，由于心房容积测量存在困难，对右心房压力与容积之间复杂关系的评估受到了阻碍。因此，在本研究中，对有和没有房间隔缺损的患者进行了右心房压力 - 容积关系动力学的研究（使用阻抗导管测量右心房容积）。在心脏导管插入术期间，使用多电极阻抗导管对16例患者测量右心房压力和阻抗容积，以提供连续的在线压力 - 容积数据。对11例无房间分流证据的患者在正常呼吸和瓦尔萨尔瓦动作期间进行了检查，并与5例经血氧饱和度升高和超声心动图研究证实有房间隔缺损的患者进行了对比。无房间隔缺损患者的右心房压力 - 容积图呈现正常的8字形模式，有一个A环（心房收缩）和一个V环（被动充盈），分别对应于右心房压力的A波和V波。吸气时，右心房平均压力降低，右心房平均容积增加，这与静脉回流增加一致。在瓦尔萨尔瓦动作时，与基线相比，右心房压力升高，右心房每搏量和右心房平均容积均降低。有房间隔缺损的患者显示出与无房间分流患者相似的基线压力 - 容积图。然而，尽管右心房压力变化与无房间隔缺损患者相似，但无论是呼吸还是瓦尔萨尔瓦动作，右心房平均容积均无变化。（摘要截短于250字）
