Department of Surgery, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan.
Department of Physiology, College of Medicine, National Taiwan University, No. 1, Sec. 1, Jen-Ai Road, Taipei, 100, Taiwan.
Pflugers Arch. 2019 Jul;471(7):935-947. doi: 10.1007/s00424-019-02270-7. Epub 2019 Mar 23.
The cardiac pumping mechanics can be characterized by both the maximal systolic elastance (E) and theoretical maximum flow (Q), which are generated using an elastance-resistance model. The signals required to fit the elastance-resistance model are the simultaneously recorded left ventricular (LV) pressure and aortic flow (Q), followed by the isovolumic LV pressure. In this study, we evaluated a single-beat estimation technique for determining the E and Q by using the elastance-resistance model based solely on the measured LV pressure and cardiac output. The isovolumic LV pressure was estimated from the measured LV pressure by using a non-linear least-squares approximation technique. The measured Q was approximated by an unknown triangular flow (Q), which was generated by using a fourth-order derivative of the LV pressure. The Q scale was calibrated using the cardiac output. Values of E and Q obtained using Q were compared with those of E and Q obtained from the measured Q. Healthy rats and rats with chronic kidney disease or diabetes mellitus were examined. We found that the LV E and Q can be approximately calculated using the assumed Q, and they strongly correlated with the corresponding values derived from Q (P < 0.0001; n = 78): E = 51.9133 + 0.8992 × E (r = 0.8257; P < 0.0001); Q = 2.4053 + 0.9767 × Q (r = 0.7798; P < 0.0001). Our findings suggest that the proposed technique can be a useful tool for determining E and Q by using a single LV pressure pulse together with cardiac output.
心脏的泵送力学可以通过最大收缩弹性(E)和理论最大流量(Q)来描述,这是使用弹性阻力模型产生的。拟合弹性阻力模型所需的信号是同时记录的左心室(LV)压力和主动脉流量(Q),随后是等容LV 压力。在这项研究中,我们评估了一种基于仅测量的 LV 压力和心输出量的弹性阻力模型来确定 E 和 Q 的单拍估计技术。等容 LV 压力是通过使用非线性最小二乘逼近技术从测量的 LV 压力估计的。测量的 Q 通过未知的三角形流量(Q)来近似,该流量是通过 LV 压力的四阶导数生成的。Q 刻度使用心输出量校准。使用 Q 获得的 E 和 Q 值与使用测量的 Q 获得的值进行比较。检查了健康大鼠、慢性肾病大鼠和糖尿病大鼠。我们发现可以使用假定的 Q 近似计算 LV E 和 Q,并且它们与从 Q 得出的相应值强烈相关(P<0.0001;n=78):E=51.9133+0.8992×E(r=0.8257;P<0.0001);Q=2.4053+0.9767×Q(r=0.7798;P<0.0001)。我们的研究结果表明,该技术可以通过使用单个 LV 压力脉冲和心输出量来确定 E 和 Q 的有用工具。