Konstam M A, Cohen S R, Salem D N, Conlon T P, Isner J M, Das D, Zile M R, Levine H J, Kahn P C
J Am Coll Cardiol. 1985 Jun;5(6):1326-34. doi: 10.1016/s0735-1097(85)80344-2.
A hemodynamic-radionuclide study was performed to compare the relations between end-systolic pressure and volume in the left and right ventricles in 10 patients with biventricular failure, and to correlate the end-systolic pressure-volume slope with baseline variables of systolic function. During nitroprusside or nitroglycerin infusion, or a combination of both, linear relations were found between end-systolic pressure and volume for both ventricles. In 9 of 10 patients, the end-systolic pressure-volume slope was greater for the left ventricle (mean +/- SD 1.12 +/- 0.36 mm Hg X m2/ml) than for the right ventricle (0.46 +/- 0.27 mm Hg X m2/ml) (p less than 0.001). In all 10 patients, the volume-axis intercept of the pressure-volume relation was greater for the left ventricle (82 +/- 66 ml/m2) than for the right ventricle (2 +/- 30 ml/m2) (p less than 0.005). Right ventricular pressure-volume slope correlated weakly with baseline right ventricular ejection fraction (r = 0.69, p less than 0.05), strongly with the baseline right ventricular end-systolic pressure-volume ratio (r = 0.89) and inversely with baseline right ventricular end-systolic volume (r = -0.86). In conclusion, 1) in patients with severe biventricular failure, changes in systolic pressure influence end-systolic volume more strongly in the right than in the left ventricle. 2) For the right ventricle, the slope of the end-systolic pressure-volume relation is directly related to rest indexes of systolic function. 3) The greater the end-systolic volume at rest, the greater the predicted improvement in right ventricular emptying for any vasodilator-induced reduction in pulmonary artery end-systolic pressure.
对10例双心室衰竭患者进行了血流动力学-放射性核素研究，以比较左、右心室收缩末期压力与容积之间的关系，并将收缩末期压力-容积斜率与收缩功能的基线变量进行关联。在输注硝普钠或硝酸甘油或两者联合使用期间，发现两个心室的收缩末期压力与容积之间呈线性关系。10例患者中有9例，左心室的收缩末期压力-容积斜率（平均±标准差1.12±0.36 mmHg×m²/ml）大于右心室（0.46±0.27 mmHg×m²/ml）（p＜0.001）。在所有10例患者中，压力-容积关系的容积轴截距左心室（82±66 ml/m²）大于右心室（2±30 ml/m²）（p＜0.005）。右心室压力-容积斜率与基线右心室射血分数弱相关（r = 0.69，p＜0.05），与基线右心室收缩末期压力-容积比强相关（r = 0.89），与基线右心室收缩末期容积呈负相关（r = -0.86）。总之，1）在严重双心室衰竭患者中，收缩压变化对右心室收缩末期容积的影响比对左心室更强。2）对于右心室，收缩末期压力-容积关系的斜率与收缩功能的静息指标直接相关。3）静息时收缩末期容积越大，任何血管扩张剂引起的肺动脉收缩末期压力降低所预测的右心室排空改善就越大。
