Haasler G B, Rodigas P C, Collins R H, Wei J, Meyer F J, Spotnitz A J, Spotnitz H M
J Thorac Cardiovasc Surg. 1985 Sep;90(3):430-40.
Quantitative two-dimensional echocardiography was evaluated in 39 open-chest dogs placed on cardiopulmonary bypass. The correlation coefficient of left ventricular end-diastolic volume against postmortem pressure-volume curves was r = 0.89 to 0.93 (347 measurements in 15 dogs, 0 to 24 mm Hg). Ejection fraction was validated against roller pump flow and echo left ventricular end-diastolic volume (r = 0.83, n = 13). Left ventricular mass in vivo was compared with postmortem left ventricular mass (r = 0.81 in 21 early studies, r = 0.91 in 10 later studies with updated equipment) and was found to increase with ischemic injury as well as cardiopulmonary bypass with hemodilution. Left ventricular mass increased (p less than 0.001) from 119 +/- 5 (standard error of the mean) to 138 +/- 6 gm (n = 23) after 2 1/2 hours on cardiopulmonary bypass and moderate hemodilution. With the addition of ischemic arrest, left ventricular mass increased from 119 +/- 7 to 148 +/- 11 gm (p less than 0.01, n = 8), and myocardial water content increased by 2.0% +/- 0.4%, which accounted for at least 65% of the observed mass change. Mean left ventricular wall thickness increased from 13.8 to 15.5 mm (p = 0.02) after ischemia. Ventricular shape became more spherical with increasing left ventricular end-diastolic pressure. We conclude that two-dimensional echocardiography can be reliably used for accurate, serial measurements in physiological studies. The demonstrated variability in left ventricular mass is important, yet frequently ignored. Recognizing left ventricular mass changes may facilitate the detection of myocardial injury reflected as edema.
对39只接受体外循环的开胸犬进行了定量二维超声心动图评估。左心室舒张末期容积与尸检压力-容积曲线的相关系数r = 0.89至0.93(15只犬的347次测量,0至24毫米汞柱)。射血分数通过滚压泵流量和超声心动图左心室舒张末期容积进行验证(r = 0.83,n = 13)。将体内左心室质量与尸检左心室质量进行比较(21项早期研究中r = 0.81,10项后期使用更新设备的研究中r = 0.91),发现其会随着缺血性损伤以及体外循环加血液稀释而增加。在体外循环和适度血液稀释2.5小时后,左心室质量从119±5(平均标准误差)增加到138±6克(n = 23)(p<0.001)。加上缺血性停搏后,左心室质量从119±7增加到148±11克(p<0.01,n = 8),心肌含水量增加2.0%±0.4%,这至少占观察到的质量变化的65%。缺血后平均左心室壁厚度从13.8毫米增加到15.5毫米(p = 0.02)。随着左心室舒张末期压力升高,心室形状变得更接近球形。我们得出结论,二维超声心动图可在生理学研究中可靠地用于准确的系列测量。所显示的左心室质量变异性很重要,但经常被忽视。认识到左心室质量变化可能有助于检测表现为水肿的心肌损伤。