Friedman H S, Scorza J, McGuinn R, Shaughnessy E
Proc Soc Exp Biol Med. 1985 Oct;180(1):1-8. doi: 10.3181/00379727-180-42135.
The changes produced by atrial fibrillation on myocardial blood flow and energetics are unclear. Accordingly, the effects of atrial fibrillation on myocardial blood flow and oxygen consumption were studied in 18 anesthetized dogs. With atrial fibrillation cardiac output and mean aortic pressure declined. Although average myocardial blood flow and oxygen consumption did not change, the alterations in these variables correlated strongly (r = 0.95, P less than 0.01). Moreover, myocardial blood flow changes correlated with those of tension time index and peak dp/dt (r = 0.64, P less than 0.05). Distribution of left ventricular regional flow remained uniform irrespective of the directional changes in blood flow. However, average left ventricular inner to outer wall flow ratio declined and myocardial oxygen extraction increased. Thus, with atrial fibrillation, myocardial blood flow does not change in a consistent fashion, although myocardial blood flow still reflects myocardial oxygen demand. Relative hypoperfusion of subendocardium and an increase in myocardial oxygen extraction suggest that with atrial fibrillation the myocardial blood flow response is abnormal.
心房颤动对心肌血流和能量代谢产生的变化尚不清楚。因此，在18只麻醉犬身上研究了心房颤动对心肌血流和氧消耗的影响。发生心房颤动时，心输出量和平均主动脉压下降。虽然平均心肌血流和氧消耗没有变化，但这些变量的改变之间存在强相关性（r = 0.95，P<0.01）。此外，心肌血流变化与张力时间指数和dp/dt峰值的变化相关（r = 0.64，P<0.05）。无论血流方向如何变化，左心室区域血流分布仍保持均匀。然而，左心室平均内膜与外膜血流比值下降，心肌氧摄取增加。因此，发生心房颤动时，心肌血流并非以一致的方式变化，尽管心肌血流仍反映心肌氧需求。心内膜下相对灌注不足和心肌氧摄取增加表明，发生心房颤动时心肌血流反应异常。
