Mangano D T, Van Dyke D C, Hickey R F, Ellis R J
J Am Coll Cardiol. 1985 Aug;6(2):290-5. doi: 10.1016/s0735-1097(85)80162-5.
To assess the effect of the pericardium, left ventricular systolic function and diastolic compliance were studied in 15 patients before and after pericardiotomy during coronary artery surgery. Using first pass radionuclide angiography, curves for left ventricular systolic function (stroke work versus end-diastolic volume) and a measure of diastolic compliance (pulmonary capillary wedge pressure versus end-diastolic volume) were generated by changing body position to alter venous return. Left ventricular end-diastolic volume ranged from 41 to 111 ml/m2 and pulmonary capillary wedge pressure from 0 to 24 mm Hg. No significant changes were found in blood pressure (150/83 to 148/82 mm Hg), heart rate (66.7 to 67.1 beats/min), cardiac index (2.38 to 2.41 liters/min per m2), ejection fraction (0.56 to 0.54), end-systolic volume index (31.4 to 32.2 ml/m2), end-diastolic volume index (65.9 to 69.5 ml/m2) or pulmonary capillary wedge pressure (7.5 to 7.3 mm Hg). The pericardium did not affect the curves relating stroke work and end-diastolic volume or those relating pulmonary capillary wedge pressure and end-diastolic volume. Thus, when filling pressure and volume are normal or only moderately elevated, the pericardium does not appear to affect left ventricular systolic function or diastolic compliance in patients.
为评估心包的作用，在15例冠状动脉手术患者心包切开术前和术后，对左心室收缩功能和舒张顺应性进行了研究。采用首次通过放射性核素血管造影术，通过改变体位以改变静脉回心血量，生成左心室收缩功能曲线（每搏功与舒张末期容积）和舒张顺应性指标曲线（肺毛细血管楔压与舒张末期容积）。左心室舒张末期容积范围为41至111ml/m²，肺毛细血管楔压范围为0至24mmHg。血压（150/83至148/82mmHg）、心率（66.7至67.1次/分钟）、心脏指数（2.38至2.41升/分钟·m²）、射血分数（0.56至0.54）、收缩末期容积指数（31.4至32.2ml/m²）、舒张末期容积指数（65.9至69.5ml/m²）或肺毛细血管楔压（7.5至7.3mmHg）均未发现显著变化。心包并未影响每搏功与舒张末期容积的关系曲线，也未影响肺毛细血管楔压与舒张末期容积的关系曲线。因此，当充盈压和容积正常或仅轻度升高时，心包似乎并不影响患者的左心室收缩功能或舒张顺应性。
