Negroni J A, Lascano E C, Pichel R H
Departamento de Investigación y Docencia de la Fundación Favaloro, Universidad de Buenos Aires, Argentina.
Circ Res. 1988 Jun;62(6):1121-33. doi: 10.1161/01.res.62.6.1121.
Computer simulation of left ventricular contraction was used to analyze the mean left ventricular pressure-mean flow relation with changes of parameter values: end-diastolic volume, contractile state, internal resistance, characteristic resistance, capacitance, end-diastolic stiffness, and heart rate and with changes of experimental conditions: filling kinetics (constant atrial pressure as opposed to constant end-diastolic volume) and coronary perfusion pressure (constant or varying with atrial pressure, i.e., self-perfused). The chamber mechanical properties used in the simulation were defined in terms of a modified purely elastic behavior model with a flow-dependent resistive component. Computed results showed that at constant end-diastolic volume and constant ventricular perfusion pressure the mean pressure-mean flow relation was linear, except for changes in internal resistance where a cubic fit of points was more appropriate. In these conditions, parameter variations in the accepted linear relation produced changes in the slope and mean pressure axis intercept. Imposition of changes in experimental conditions gave rise to nonlinear mean pressure-mean flow relations. The results indicate that with elastic-resistive chamber mechanical properties as a starting point, the experimental conditions would be responsible for the different shapes of the mean pressure-mean flow relation obtained in isolated heart experiments. However, a more complete description of chamber properties (such as the addition of a deactivation component) could also give rise to nonlinear pump function graphs.
利用左心室收缩的计算机模拟,分析了参数值(舒张末期容积、收缩状态、内阻、特征阻力、电容、舒张末期硬度和心率)变化以及实验条件(充盈动力学,即恒定心房压力与恒定舒张末期容积相对;冠状动脉灌注压力,恒定或随心房压力变化,即自灌注)变化时左心室平均压力 - 平均流量关系。模拟中使用的心室力学特性是根据具有流量依赖性阻力成分的修正纯弹性行为模型定义的。计算结果表明,在舒张末期容积和心室灌注压力恒定时,平均压力 - 平均流量关系呈线性,但内阻变化时,点的三次拟合更为合适。在这些条件下,公认的线性关系中的参数变化会导致斜率和平均压力轴截距的变化。实验条件的改变会产生非线性的平均压力 - 平均流量关系。结果表明,以弹性 - 阻力心室力学特性为出发点,实验条件会导致在离体心脏实验中获得的平均压力 - 平均流量关系具有不同形状。然而,对心室特性更完整的描述(如添加失活成分)也可能产生非线性的泵功能图。