Osbakken M, Young M, Huddell J, Closter J, Prammer M, Chance B
Department of Anesthesia, University of Pennsylvania, Philadelphia 19104.
Magn Reson Med. 1988 Jun;7(2):143-55. doi: 10.1002/mrm.1910070203.
To study the effects of acute volume loading on myocardial metabolic and mechanical function, seven cats were volume loaded via anastomosis of the abdominal aorta to the vena cava (AV shunt). Metabolic effects were evaluated with 31P nuclear magnetic resonance (NMR). Mechanical function was evaluated with heart rate X systolic blood pressure product (HR X SBP). Shunts were opened for 1-2 h during which time phosphocreatine (PCr), adenosine triphosphate (ATP), inorganic phosphate (Pi), and HR X SBP were monitored. High-energy phosphate energetics as determined by Pi/PCr and PCr/ATP ratios were correlated with HR X SBP. Opening of the AV shunts was associated with an increase (four cats) or a decrease (three cats) in HR X SBP. Pi/PCr ratios increased and PCr/ATP ratios decreased in cats with an increase in HR X SBP. In cats with a decrease in HR X SBP, Pi/PCr and PCr/ATP generally did not change significantly. In summary, acute volume loading could be associated with an increase or decrease in myocardial external work as evaluated by HR X SBP, accompanied by metabolic changes suggestive of appropriate induction of state 3 metabolism (active metabolic state: ADP + Pi----ATP) in those cats with increased mechanical work, and minimal change in bioenergetics in cats with no or minimal increase in mechanical work. These induced metabolic responses to myocardial mechanical loading can be evaluated with 31P NMR techniques and may provide insight into in vivo metabolic control mechanisms.
为研究急性容量负荷对心肌代谢及机械功能的影响,通过将腹主动脉与腔静脉吻合(动静脉分流)对7只猫进行容量负荷。采用31P核磁共振(NMR)评估代谢效应。采用心率×收缩压乘积(HR×SBP)评估机械功能。分流开放1 - 2小时,在此期间监测磷酸肌酸(PCr)、三磷酸腺苷(ATP)、无机磷酸(Pi)以及HR×SBP。由Pi/PCr和PCr/ATP比值所确定的高能磷酸化合物能量学与HR×SBP相关。动静脉分流开放后,HR×SBP出现升高(4只猫)或降低(3只猫)。HR×SBP升高的猫,Pi/PCr比值升高,PCr/ATP比值降低。HR×SBP降低的猫,Pi/PCr和PCr/ATP通常无显著变化。总之,急性容量负荷可使通过HR×SBP评估的心肌外功增加或减少,伴有代谢变化,提示机械功增加的猫适度诱导了3型代谢状态(活跃代谢状态:ADP + Pi→ATP),而机械功无增加或增加极少的猫生物能量学变化极小。这些对心肌机械负荷诱导的代谢反应可用31P NMR技术进行评估,可能有助于深入了解体内代谢控制机制。