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升主动脉狭窄与降主动脉狭窄猪模型的左心室压力-容积面积和每搏功与慢性早期和晚期左心室后负荷增加的关系。

The Left Ventricular Pressure-Volume Area and Stroke Work in Porcine Model of Ascending Compared to Descending Thoracic Aorta Stenosis Creating a Chronic Early Vs. Late Left Ventricular Afterload Increase.

机构信息

Imaging and Dynamics, Department of Cardiovascular Sciences, Medical Faculty, Katholieke Universiteit of Leuven, Leuven, Belgium.

出版信息

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2022 Jul 13;43(2):111-121. doi: 10.2478/prilozi-2022-0024.

Abstract

: Left ventricular hypertrophy in aortic stenosis, arterial hypertension or coarctation of the aorta is risk factor for early development of HF. In chronic late compared to early left ventricular afterload increases resulting from descending thoracic оr ascending aorta stenosis, we assess the left ventricular stroke work, pressure-volume area for О demand and effective work on the 4 and 8 weeks. It is suggested that reduced proximal thoracic aortic compliance presents with myocardial ischemia. However, development of adverse left ventricular hypertrophic remodeling and HF in different peak of LV afterload increase is understood poorly. : Fourteen domestic male pigs (28 ± 3 kg) underwent descending thoracic or ascending aortic stenosis through posterior lateral thoracotomy, with cMRI and an invasive left ventricular pressure-volume loops' аrea assessment (Millar 5Fr pig-tailed conductance catheter) on the 4 and 8 weeks. Left ventricular stroke work and pressure-volume area PVA, parameter for LV O demand, were assessed in hypertrophic left ventricular remodeling, resulting from different peaks in LV afterload (late vs. early LV afterload) increase and we thus defined early adverse LV hypertrophic remodeling in linear and nonlinear end-systolic pressure-volume regression analysis. For this we used special software. Data was compared with two-way repeated measures ANOVA. Results presented are means ± (SEM) or medians and significance is set at p < 0.05. : The left ventricular nonlinear PVA was not different, in LL compared to EL on the 8 week and when using the linear regression analysis. Stroke work was not different. The linear and nonlinear potential energy were not different between LL vs. the EL group. Nonlinear bLVO demand was not different, being higher in LL compared to EL in the 8 week. Indexed PVA parameters were not different or changed between the 4 and 8 weeks, when being normalized for body surface-area (m²) or 100 grams of LV mass. : The left ventricular potential energy, PVA with effective work and LVO2 demands are not different in hypertrophic LV remodeling in LL vs. EL group at the 8 week. Difference is not present when end-systolic pressure-volume relation is assessed from indexed LV volumes for m² BSA or 100 grams of LV mass. EL is as important as LL in increased LV afterloads based on LV work and mechanical coupling in this hypertensive heart failure model having preserved EF.

摘要

主动脉瓣狭窄、动脉高血压或主动脉缩窄导致的左心室肥厚是 HF 早期发展的危险因素。在慢性晚期,与早期相比,由于降胸段或升主动脉狭窄导致的后负荷增加,我们评估了左心室每搏功、压力-容积面积与 O 需求和有效功。有人提出,近端胸主动脉顺应性降低与心肌缺血有关。然而,不同 LV 后负荷峰值增加的不良左心室肥厚重塑和 HF 发展理解甚少。

14 只国内雄性猪(28±3kg)通过后外侧开胸术进行降胸段或升主动脉狭窄,在 4 周和 8 周时进行 cMRI 和侵入性左心室压力-容积环面积评估(Millar 5Fr 猪尾传导导管)。在不同 LV 后负荷峰值(晚期 vs. 早期 LV 后负荷)增加导致的肥厚性左心室重塑中,评估了左心室每搏功和压力-容积面积 PVA,这是 LV O 需求的参数,我们通过线性和非线性端收缩压力-容积回归分析来定义早期不良 LV 肥厚重塑。为此,我们使用了特殊软件。数据采用双因素重复测量方差分析进行比较。结果以均值±(SEM)或中位数表示,意义设定为 p<0.05。

与 8 周时的 EL 相比,在 LL 中,左心室非线性 PVA 没有差异。线性回归分析也没有差异。在 LL 与 EL 组之间,每搏功没有差异。线性和非线性潜能没有差异。在 8 周时,非线性 bLVO 需求在 LL 中高于 EL。当 PVA 参数标准化为体表面积(m²)或 100 克左心室质量时,在 4 周和 8 周之间没有差异或发生变化。

在 8 周时,在 LL 与 EL 组的肥厚性 LV 重塑中,左心室潜在能量、PVA 与有效功和 LVO2 需求没有差异。当根据 m²BSA 或 100 克左心室质量的左心室容量进行指数化时,左心室压力-容积关系的评估没有差异。在这种具有保留 EF 的高血压性心力衰竭模型中,基于 LV 工作和机械偶联,EL 与 LL 一样重要,在增加 LV 后负荷方面。

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