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健康年轻男性的左心室收缩末期压力-容积关系

Left ventricular end-systolic pressure volume relations in healthy young men.

作者信息

Winnem M, Piene H

出版信息

Eur Heart J. 1986 Nov;7(11):961-72. doi: 10.1093/oxfordjournals.eurheartj.a062001.

Abstract

The purpose of the present study was to establish the relationship of left ventricular end-systolic volume vs. mean systemic pressure in variously afterloaded beats in a group of healthy, young, men (n = 6, age 24 +/- 0.9 years). The relationship was expressed by the slope (Emax) of the line connecting pressure-volume co-ordinates and its extrapolated intercept (Vd) of the volume axis. The slope was calculated by linear regression of mean systemic arterial pressure (mean SAP, measured by catheter in the radial artery) vs. end-systolic left ventricular volume (ESV, estimated from cross-sectional, 4-chamber echocardiographic images). Recordings were obtained at resting, reduced (nitroglycerin infusion), and elevated (metaoxedrin infusion) blood pressure. Individual Emax values ranged from 1.05 to 2.01 mmHg ml-1; Vd was consistently found to be negative, ranging from -4.7 to -54.8 ml. All individual relations were statistically significant (P less than 0.05 to P less than 0.001). Group values were Emax = 1.27 +/- 0.25 (SE) mmHg ml-1, Vd = -43.3 +/- 7.5 (SE) ml, and Emax indexed for body surface area, Emax ind = 2.54 +/- 0.49 (SE) mmHg ml-1 m-2. We further examined the validity of proposed optimal relations among Emax, heart rate (HR) and systemic resistance (Rs): Emax/HR = Rs, and among ejection fraction (EF), EDV and Vd: EF = 0.5 (1 - EDV/Vd). For the group Emax/HR = 0.023 +/- 0.003 and Rs = 0.016 +/- 0.004 (mmHg ml-1 min-1), i.e., a deviation from equivalence of 30% (P less than 0.001). EF (= 0.72 +/- 0.02) deviated by 18% (P less than 0.001) from its proposed optimum (0.5 (1 - Vd/EDV) = 0.61 +/- 0.06).

摘要

本研究的目的是确定一组健康年轻男性(n = 6,年龄24±0.9岁)在不同后负荷搏动情况下左心室收缩末期容积与平均体循环压力之间的关系。这种关系通过连接压力-容积坐标的直线斜率(Emax)及其在容积轴上的外推截距(Vd)来表示。斜率通过平均体循环动脉压(通过桡动脉导管测量的平均SAP)与收缩末期左心室容积(ESV,根据四腔心切面超声心动图图像估算)的线性回归计算得出。在静息、血压降低(静脉输注硝酸甘油)和血压升高(静脉输注甲氧明)状态下进行记录。个体的Emax值范围为1.05至2.01 mmHg ml-1;Vd始终为负值,范围为-4.7至-54.8 ml。所有个体关系均具有统计学意义(P小于0.05至P小于0.001)。组均值为Emax = 1.27±0.25(SE)mmHg ml-1,Vd = -43.3±7.5(SE)ml,以及经体表面积指数化的Emax,Emax ind = 2.54±0.49(SE)mmHg ml-1 m-2。我们进一步检验了Emax、心率(HR)和体循环阻力(Rs)之间提议的最佳关系Emax/HR = Rs,以及射血分数(EF)、舒张末期容积(EDV)和Vd之间的关系EF = 0.5(1 - EDV/Vd)的有效性。对于该组,Emax/HR = 0.023±0.003且Rs = 0.016±0.004(mmHg ml-1 min-1),即与等效值偏差30%(P小于0.001)。EF(= 0.72±0.02)与其提议的最佳值(0.5(1 - Vd/EDV)= 0.61±0.06)偏差18%(P小于0.001)。

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