Di Lorenzo M, Giannazzo E, Giuffrida R, Sapienza S
Boll Soc Ital Biol Sper. 1985 Mar 30;61(3):365-72.
The aim of the present study was to detect simultaneously hemodynamic parietal events and intraluminal pressure of the Lower Esophageal Sphincter (LES), with particular regards to cyclic changes due to systo-diastolic cardiac activity. A probe for combined Intraluminal Manometric Plethysmography (IMP) and Intraluminal Impedence Plethysmography (IIP) was used. It was a Swan Ganz bipolar pacing catheter, modified by removing the latex balloon from the tip. The exposed side-hole (diameter smaller than 0.5 mm) was utilized as a terminal orifice for an infused manometry system. It was preliminarly essayed in bench tests. A perfusion rate of 1.75 ml/min was chosen as it did not induce significant elevations of the pressure base-line and allowed detection of pressure rise rates up to 300 mm Hg/s. The two metallic rings, originally designed for intracardiac stimulation, were used as low resistance electrodes to record impedence variations. Since very small shifts of recording electrodes induce important artifacts, the present experiments were carried out on curarized cats. In these conditions, artificial ventilation could be temporarily stopped to avoid any artifact due to respiration mechanics. The proposed method seems to be satisfactory enough for simultaneous acquisition of IIP and IMP data at LES level. Recordings of IIP allow to reveal changes in parietal blood content which could chiefly be referred to lamina propria and submucosa districts. On the other hand, IMP cyclic fluctuations would signal variations of total sphincteric tension, likely depending on hemodynamic events in all vascular beds of the wall. In our opinion, a more extensive analysis of IMP and IIP waves, as well as of reciprocal relationships between rheografic and manometric parameters, may provide very useful knowledges on sphincteric physiology.
本研究的目的是同时检测下食管括约肌（LES）的血流动力学壁内事件和腔内压力，特别关注由于心脏舒缩活动引起的周期性变化。使用了一种用于联合腔内压力容积描记法（IMP）和腔内阻抗容积描记法（IIP）的探头。它是一根经改良的Swan Ganz双极起搏导管，其尖端的乳胶球囊已被移除。暴露的侧孔（直径小于0.5毫米）被用作注入式测压系统的终端孔口。它在台架试验中进行了初步测试。选择1.75毫升/分钟的灌注速率，因为它不会引起压力基线的显著升高，并且能够检测高达300毫米汞柱/秒的压力上升速率。最初设计用于心脏内刺激的两个金属环被用作低电阻电极来记录阻抗变化。由于记录电极的非常小的移动会引起重要的伪像，因此本实验是在箭毒化的猫身上进行的。在这些条件下，可以暂时停止人工通气，以避免由于呼吸力学引起的任何伪像。所提出的方法似乎足以令人满意地在LES水平同时采集IIP和IMP数据。IIP记录可以揭示壁内血容量的变化，这些变化主要可能与固有层和黏膜下层区域有关。另一方面，IMP的周期性波动将表明总括约肌张力的变化，这可能取决于壁内所有血管床的血流动力学事件。我们认为，对IMP和IIP波以及流变学和测压参数之间的相互关系进行更广泛的分析，可能会提供有关括约肌生理学的非常有用的知识。
