Yaginuma T, Noda T, Tsuchiya M, Takazawa K, Tanaka H, Kotoda K, Hosoda S
Jpn Circ J. 1985 Feb;49(2):206-14. doi: 10.1253/jcj.49.206.
Implication of aortic input impedance and left ventricular coupling were investigated in three series of studies. In a clinical study, the ascending aortic flow velocity and pressure were simultaneously recorded from a multisensor catheter, and input impedance was calculated from 8 harmonics of aortic pressure and flow. Left ventricular wall stress was calculated from diameters and wall thickness of cineventriculogram and simultaneous recording of left ventricular pressure. In the experimental study, programmable artificial pulsatile pump was used to control pulsatile blood flow in dogs. The pressure-flow relationship in the arterial system had slightly convex curves toward the pressure axis with a critical turning pressure, so the arterial system had low output--high resistance and high output--low resistance characteristics. Therefore, the failed heart should inevitably eject the blood against stiffened vascular beds. Increased work load of the ventricle as expressed by sustained ventricular wall stress was determined mainly by the exaggerated late systolic pressure due to increased input resistance and increased low frequency pulsatile component of the input impedance. These findings are especially important for relieving additional work load of the ischemic heart, which have higher pressure wave reflection.
在三个系列的研究中，对主动脉输入阻抗和左心室耦合的影响进行了研究。在一项临床研究中，使用多传感器导管同时记录升主动脉血流速度和压力，并根据主动脉压力和血流的8个谐波计算输入阻抗。根据心脏造影的直径和壁厚以及左心室压力的同步记录来计算左心室壁应力。在实验研究中，使用可编程人工搏动泵来控制犬的搏动性血流。动脉系统中的压力-流量关系朝着压力轴呈轻微凸曲线，具有临界转折压力，因此动脉系统具有低输出-高阻力和高输出-低阻力特性。因此，衰竭心脏不可避免地要在僵硬的血管床中射血。以持续的心室壁应力表示的心室工作负荷增加主要是由输入阻力增加导致的收缩期末期压力过高以及输入阻抗的低频搏动成分增加所决定的。这些发现对于减轻缺血性心脏的额外工作负荷尤为重要，因为缺血性心脏具有更高的压力波反射。
