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急性实验性心力衰竭时左心室收缩的机制

The mechanics of left ventricular contraction in acute experimental cardiac failure.

作者信息

Ross J, Covell J W, Sonnenblick E H

出版信息

J Clin Invest. 1967 Mar;46(3):299-312. doi: 10.1172/JCI105532.

DOI:10.1172/JCI105532
PMID:4381563
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC297051/
Abstract

The effects of acute cardiac failure induced by pentobarbital or pronethalol on the basic mechanical properties of the intact left ventricle were examined in the dog, and the influence on auxotonic and isovolumic contractions of the increase in end-diastolic volume that usually accompanies cardiac failure was assessed. The right heart bypass preparation was employed, and isovolumic beats were induced by sudden balloon occlusion of the aortic root. The ventricular pressure-volume curve was determined directly, and the mechanical responses of the myocardial fibers and contractile elements were calculated.When end-diastolic pressure was held constant, failure reduced the extent of circumferential fiber shortening, and the tension-velocity relation calculated during isovolumic beats was always shifted, with reductions in both maximal velocity (average decrease 30%) and maximal developed tension (average 23%); in addition, during failure achievement of maximal contractile element velocity and maximal tension was delayed, whereas the total duration of contraction was always prolonged. Acetylstrophanthidin tended to reverse all of these changes. When end-diastolic volume was augmented during failure at a constant stroke volume, the extent of circumferential fiber shortening was reduced (3.82 cm to 2.02 cm), and during ejection the fiber and contractile element velocities were diminished at wall tensions comparable to control; maximal velocity and velocity at peak tension were also decreased. The tension-velocity relation during isovolumic beats was shifted by failure with consistent reductions in maximal shortening velocity, but changes in maximal tension were small. Maximal instantaneous power was always reduced by failure, and a striking alteration occurred in the relation between work expended in stretching the series elastic component and the external work; the former, "internal work," increased by an average of 90%, the latter diminished by 11%, and the total contractile element work remained essentially unchanged. These findings are discussed within the framework of a three dimensional model that included fiber length, wall tension, and contractile element velocity. The experimental techniques employed appear to permit a more complete definition of the abnormalities of the ventricular myocardium in experimental failure. They are potentially applicable in the closed-chest animal and allow quantitative determinations of the contractile properties of the left ventricle.

摘要

在犬身上研究了戊巴比妥或普萘洛尔诱导的急性心力衰竭对完整左心室基本力学特性的影响,并评估了心力衰竭通常伴随的舒张末期容积增加对辅助性收缩和等容收缩的影响。采用右心旁路制备方法,通过突然用球囊阻断主动脉根部诱导等容搏动。直接测定心室压力-容积曲线,并计算心肌纤维和收缩成分的力学反应。当舒张末期压力保持恒定时,心力衰竭会降低圆周纤维缩短的程度,等容搏动期间计算的张力-速度关系总是发生偏移,最大速度(平均降低30%)和最大发展张力(平均23%)均降低;此外,在心力衰竭期间,最大收缩成分速度和最大张力的达到延迟,而收缩总持续时间总是延长。乙酰洋地黄毒苷倾向于逆转所有这些变化。当在心力衰竭期间以恒定搏出量增加舒张末期容积时,圆周纤维缩短的程度降低(从3.82厘米降至2.02厘米),在射血期间,与对照相当的壁张力下纤维和收缩成分的速度降低;最大速度和峰值张力时的速度也降低。等容搏动期间的张力-速度关系因心力衰竭而发生偏移,最大缩短速度持续降低,但最大张力变化较小。心力衰竭总是会降低最大瞬时功率,并且在拉伸串联弹性成分所消耗的功与外部功之间的关系发生了显著改变;前者,即“内功”,平均增加90%,后者减少11%,而收缩成分的总功基本保持不变。在一个包括纤维长度、壁张力和收缩成分速度的三维模型框架内讨论了这些发现。所采用的实验技术似乎允许更完整地定义实验性心力衰竭时心室心肌的异常情况。它们有可能应用于闭胸动物,并允许对左心室的收缩特性进行定量测定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a93c/297051/f4e575103fdd/jcinvest00231-0032-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a93c/297051/f4e575103fdd/jcinvest00231-0032-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a93c/297051/f4e575103fdd/jcinvest00231-0032-a.jpg

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