Sibbald W J, Driedger A A, Cunningham D G, Cheung H
Crit Care Med. 1986 Oct;14(10):852-7. doi: 10.1097/00003246-198610000-00003.
We examined biventricular performance on two occasions in 28 patients with acute hypoxemic respiratory failure (ARF), using a combination of invasively determined pressures and flows as well as radionuclide scintigraphy to measure the right and left ventricular ejection fractions (RVEF and LVEF, respectively). From the EF and concurrently measured thermodilution stroke volumes, we calculated right and left ventricular end-diastolic and end-systolic volume indices (EDVI and ESVI, respectively). Regression analysis demonstrated that changes (delta) in global right ventricular function (RVEF) were inversely correlated with concurrent changes in the mean pulmonary arterial pressure (MPAP): delta RVEF = 0.015-0.015 delta MPAP (r2 = 0.60; p less than .005), while an increase in right ventricular preload (RVEDVI) was positively correlated with changes in MPAP: delta RVEDVI = 2.68 +/- 6.27 delta MPAP (r2 = 0.46; p less than .005). Global left ventricular function (LVEF) was related to changes in systemic pressures as well as to right-sided events: delta LVEF = -0.01-0.0015(delta RVESVI) + 0.001(delta BP systolic)-0.42(CVP/RVEDVI) (r2 = 0.35; p less than .01). These data confirm the significant influence of right ventricular afterload on RVEF in ARF patients and an apparent interrelationship between altered right ventricular systolic function and global left ventricular performance.
我们对28例急性低氧性呼吸衰竭（ARF）患者进行了两次双心室功能检查，采用有创测定的压力和流量以及放射性核素闪烁显像相结合的方法，分别测量右心室和左心室射血分数（RVEF和LVEF）。根据射血分数和同时测量的热稀释法心搏量，我们计算了右心室和左心室舒张末期及收缩末期容积指数（分别为EDVI和ESVI）。回归分析表明，整体右心室功能（RVEF）的变化（δ）与平均肺动脉压（MPAP）的同时变化呈负相关：δRVEF = 0.015 - 0.015δMPAP（r2 = 0.60；p < 0.005），而右心室前负荷增加（RVEDVI）与MPAP的变化呈正相关：δRVEDVI = 2.68 ± 6.27δMPAP（r2 = 0.46；p < 0.005）。整体左心室功能（LVEF）与体循环压力变化以及右侧事件有关：δLVEF = -0.01 - 0.0015（δRVESVI） + 0.001（δ收缩压） - 0.42（CVP/RVEDVI）（r2 = 0.35；p < 0.01）。这些数据证实了右心室后负荷对ARF患者RVEF有显著影响，以及右心室收缩功能改变与整体左心室功能之间存在明显的相互关系。
