Toeda T, Yamazoe M, Hoshino Y, Murata M, Arai Y, Shibata A
Jpn Heart J. 1985 May;26(3):349-61. doi: 10.1536/ihj.26.349.
Analysis of beat to beat changes in left ventricular (LV) ejection time during cardiac pacing was utilized to assess the atrial contribution to ventricular filling in 30 consecutive patients undergoing diagnostic cardiac catheterization. The group consisted of 9 normal subjects, 18 with coronary artery disease and 3 with congestive cardiomyopathy. The recordings of aortic pressure were made during atrial pacing and ventricular pacing at a rate 5 to 10 beats/min above each individual's sinus rhythm. During ventricular pacing, LV ejection time was the longest when an atrial contraction preceded a ventricularly paced beat by a physiologic interval and was approximately similar to that obtained during atrial pacing (maxET). When the atrial systole occurred with or followed the ventricularly paced contraction, LV ejection time was decreased (minET). Since maxET occurred in the presence of an effective atrial contraction to ventricular filling and minET in the absence of this contraction, the atrial contribution to ventricular filling was calculated as (maxET-minET)/maxET X 100 (%). LV volumes at end-systole (V1), before atrial contraction (V2) and at end-diastole (V3) were obtained according to the area-length method by tracing the silhouette of left ventriculograms using a computer system. The atrial contribution was calculated from LV volumes using the formula (V3-V2)/(V3-V1) X 100 (%). There was a good correlation (r = 0.88) between the atrial contributions calculated from LV ejection times and those calculated from LV volumes. In the patients with coronary artery disease and with congestive cardiomyopathy, the atrial contribution was significantly greater than in the normal subjects. The measurement of LV ejection time during ventricular pacing may be a clinically useful screening procedure to identify patients in whom physiologic pacing may be indicated.
对30例接受诊断性心导管检查的连续患者，利用心脏起搏期间左心室（LV）射血时间的逐搏变化分析来评估心房对心室充盈的作用。该组包括9名正常受试者、18名冠心病患者和3名充血性心肌病患者。在心房起搏和心室起搏期间，以高于每个个体窦性心律5至10次/分钟的频率记录主动脉压力。在心室起搏期间，当心房收缩先于心室起搏搏动一个生理间期时，LV射血时间最长，且与心房起搏期间获得的射血时间（最大射血时间）大致相似。当心房收缩与心室起搏收缩同时发生或跟随心室起搏收缩时，LV射血时间缩短（最小射血时间）。由于最大射血时间出现在存在有效的心房收缩促进心室充盈时，而最小射血时间出现在不存在这种收缩时，因此心房对心室充盈的作用计算为（最大射血时间 - 最小射血时间）/最大射血时间×100（%）。根据面积 - 长度法，使用计算机系统追踪左心室造影轮廓，获取收缩末期（V1）、心房收缩前（V2）和舒张末期（V3）的LV容积。根据公式（V3 - V2）/（V3 - V1）×100（%）从LV容积计算心房作用。从LV射血时间计算的心房作用与从LV容积计算的心房作用之间存在良好的相关性（r = 0.88）。在冠心病患者和充血性心肌病患者中，心房作用明显大于正常受试者。心室起搏期间LV射血时间的测量可能是一种临床上有用的筛查方法，用于识别可能需要生理性起搏的患者。
