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右心室缺血对犬左心室几何形态及舒张末期压力-容积关系的影响。

Effects of right ventricular ischemia on left ventricular geometry and the end-diastolic pressure-volume relationship in the dog.

作者信息

Goto Y, Yamamoto J, Saito M, Haze K, Sumiyoshi T, Fukami K, Hiramori K

出版信息

Circulation. 1985 Nov;72(5):1104-14. doi: 10.1161/01.cir.72.5.1104.

Abstract

We studied the effects of right ventricular ischemia on left ventricular three-dimensional geometry and the end-diastolic pressure-volume relationship in 16 open-chest dogs before and after pericardiectomy. Left ventricular volume was calculated from three internal dimensions measured with ultrasonic crystals. In one group of eight dogs, right coronary artery (RCA) occlusion for 2 min with the pericardium intact reduced aortic flow by 24 +/- 9% (p less than .001) and septal-lateral dimension by 8 +/- 5% (p less than .01), without changing anterior-posterior and apical-basal dimensions. However, parameters of left ventricular systolic function (aortic flow, left ventricular systolic pressure, peak dP/dt, and mean percent systolic shortening) were similar to those observed at a comparable level of left ventricular end-diastolic volume during inferior vena caval occlusion. In the other group of eight dogs, during RCA occlusion before pericardiectomy the left ventricular end-diastolic pressure-volume relationship determined during rapid blood transfusion shifted leftward and upward significantly from the preocclusion relationship. After pericardiectomy, RCA occlusion caused less significant changes in aortic flow and septal-lateral dimension as well as in the left ventricular end-diastolic pressure-volume relationship. We concluded that right ventricular ischemia causes a leftward shift of the interventricular septum in end-diastole and an alteration of the left ventricular end-diastolic pressure-volume relationship without changing left ventricular myocardial performance. These changes are enhanced by the intact pericardium.

摘要

我们研究了在16只开胸犬心包切除前后,右心室缺血对左心室三维几何形状和舒张末期压力-容积关系的影响。左心室容积通过用超声晶体测量的三个内径来计算。在一组8只犬中,心包完整时右冠状动脉(RCA)闭塞2分钟使主动脉血流量减少24±9%(p<0.001),室间隔-侧壁内径减少8±5%(p<0.01),而前后径和心尖-心底径未改变。然而,左心室收缩功能参数(主动脉血流量、左心室收缩压、峰值dP/dt和平均收缩期缩短百分比)与在下腔静脉闭塞期间左心室舒张末期容积相当水平时观察到的参数相似。在另一组8只犬中,心包切除前RCA闭塞期间,快速输血时测定的左心室舒张末期压力-容积关系与闭塞前的关系相比显著向左上方移位。心包切除后,RCA闭塞引起的主动脉血流量、室间隔-侧壁内径以及左心室舒张末期压力-容积关系的变化较小。我们得出结论,右心室缺血导致舒张末期室间隔向左移位,以及左心室舒张末期压力-容积关系改变,而不改变左心室心肌性能。完整的心包会加剧这些变化。

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