Matsuno Y, Morioka S, Murakami Y, Kobayashi S, Moriyama K
4th Department of Internal Medicine, Shimane Medical University, Izumo City, Japan.
Clin Cardiol. 1988 Oct;11(10):702-6. doi: 10.1002/clc.4960111009.
To determine the mechanism for prolongation of pre-ejection period (PEP) in the hypertensive heart with normal systolic function, cardiac catheterizations, echocardiograms, and electrocardiograms were performed at the baseline period (CS, control stage) and eight weeks (HS, hypertensive stage) after the induction of systemic hypertension by Page's method in unanesthetized dogs. Mean aortic blood pressure increased significantly (96 +/- 12 to 137 +/- 26 mmHg) (p less than 0.05). Diastolic aortic pressure also increased significantly (80 +/- 12 to 118 +/- 24 mmHg) (p less than 0.01). Left ventricular (LV) PEP of HS was significantly prolonged (72 +/- 12 vs. 87 +/- 22 ms, CS vs. HS). The ratio of LV pre-ejection period to ejection time (PEP/ET) also increased significantly (0.33 +/- 0.04 to 0.42 +/- 0.07) (p less than 0.05). LV end-diastolic wall stress as an index of preload decreased significantly (7.7 +/- 2.5 vs. 5.9 +/- 1.8 10(3) dynes/cm2, CS vs. HS). Heart rate, mean velocity of circumferential fiber shortening (VCF) and end-systolic wall stress of HS did not change. That is, myocardial contractility in the hypertensive heart of HS most likely is not depressed. At autopsy, left ventricle to body weight ratio of HS was significantly (p less than 0.01) greater than the sham-operated dogs (5.7 +/- 0.8 vs. 4.3 +/- 0.5 g/kg). From these findings, there are two possible factors responsible for prolongation of PEP of HS. First, elevated diastolic aortic pressure may influence PEP. Second, the prolonged PEP is possibly caused by the decrease of preload.(ABSTRACT TRUNCATED AT 250 WORDS)
为确定收缩功能正常的高血压心脏射血前期(PEP)延长的机制,采用佩奇法在未麻醉犬身上诱导全身性高血压,于基线期(CS,对照阶段)和诱导后八周(HS,高血压阶段)进行心导管检查、超声心动图和心电图检查。平均主动脉血压显著升高(96±12至137±26 mmHg)(p<0.05)。舒张期主动脉压也显著升高(80±12至118±24 mmHg)(p<0.01)。HS组的左心室(LV)PEP显著延长(CS组与HS组:72±12 vs. 87±22 ms)。左心室射血前期与射血时间的比值(PEP/ET)也显著增加(0.33±0.04至0.42±0.07)(p<0.05)。作为前负荷指标的左心室舒张末期壁应力显著降低(CS组与HS组:7.7±2.5 vs. 5.9±1.8×10³达因/cm²)。HS组的心率、圆周纤维缩短平均速度(VCF)和收缩末期壁应力未改变。也就是说,HS组高血压心脏的心肌收缩力很可能未受抑制。尸检时,HS组左心室与体重的比值显著高于假手术犬(p<0.01)(5.7±0.8 vs. 4.3±0.5 g/kg)。基于这些发现,有两个可能因素导致HS组PEP延长。第一,升高的舒张期主动脉压可能影响PEP。第二,PEP延长可能是由前负荷降低引起的。(摘要截于250字)