Nonogi H, Hess O M, Ritter M, Krayenbuehl H P
Medical Policlinic, Cardiology, University Hospital, Zurich, Switzerland.
Br Heart J. 1988 Jul;60(1):30-8. doi: 10.1136/hrt.60.1.30.
Diastolic function in response to dynamic exercise was studied by biplane left ventriculography and by measuring left ventricular pressure with a high fidelity micromanometer tipped catheter at rest and during supine bicycle exercise in nine normal subjects. During exercise there was a fall in end systolic volume, in the time constant of left ventricular isovolumic pressure decay, and in the lowest diastolic pressure. Stroke volume, peak filling rate, mean passive filling rate, and the volume at the lowest diastolic pressure increased. There was an increase in the number of time constants that had elapsed before the lowest diastolic pressure was reached and the slope of the pressure-volume curves during passive filling (delta P/delta V) increased without changes in end diastolic pressure and volume. These results show that during exercise elastic recoil is enhanced and left ventricular relaxation is faster and more complete. Both phenomena reduce the lowest diastolic filling pressure. The observed increase in chamber stiffness from rest to exercise is probably related to increased resistance of the left ventricular wall caused by higher passive filling rates. The enhanced early diastolic pressure decay during exercise allows stroke volume to increase despite an increase in diastolic viscoelastic resistance and chamber stiffness.
通过双平面左心室造影以及使用高保真微测压头导管在9名正常受试者静息状态和仰卧位自行车运动期间测量左心室压力，研究了动态运动时的舒张功能。运动期间，收缩末期容积、左心室等容压力衰减的时间常数以及最低舒张压均下降。每搏输出量、峰值充盈率、平均被动充盈率以及最低舒张压时的容积增加。在达到最低舒张压之前经过的时间常数数量增加，被动充盈期间压力-容积曲线的斜率（ΔP/ΔV）增加，而舒张末期压力和容积无变化。这些结果表明，运动期间弹性回缩增强，左心室舒张更快且更完全。这两种现象均降低了最低舒张充盈压。观察到的从静息到运动时心室僵硬度增加可能与较高的被动充盈率导致的左心室壁阻力增加有关。运动期间舒张早期压力衰减增强，尽管舒张期粘弹性阻力和心室僵硬度增加，但仍使每搏输出量增加。
