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左心室尺寸急性增加期间心室心内膜和心外膜电位的降低。

Reduction in ventricular endocardial and epicardial potentials during acute increments in left ventricular dimensions.

作者信息

Lekven J, Chatterjee K, Tyberg J V, Parmley W W

出版信息

Am Heart J. 1979 Aug;98(2):200-6. doi: 10.1016/0002-8703(79)90222-9.

Abstract

Unipolar potentials were recorded from the endocardium (Endo-Pot) and the epicardium (Epi-Pot) of the left and right ventricles of anesthetized open-chested dogs during acute changes in left ventricular dimension by blood transfusion. A pair of implanted ultrasonic crystals were used to detail changes in left ventricular (LV) anteroposterior diameter. When the diameter increased by an average of 11 per cent, LV Endo-Pot decreased by 28 per cent and LV Epi-Pot decreased by 15 per cent. Right ventricular Endo-Pot and Epi-Pot concurrently decreased by similar magnitude (-36 per cent). The relationship between potentials and LV diameter showed negative linearity over the ranges examined, and was not influenced by changes in hematocrit. No inverse relation between changes in Endo-Pot and Epi-Pot was observed. It is suggested that potentials when recorded directly from the endocardium or epicardium mainly reflect the electrical activity of the tissues in the immediate vicinity of the electrode. It is postulated that an increase in ventricular volume by producing stretching and thinning of ventricular walls, reduces the effective tissue mass represented in the electrode signal, thereby accounting for a reduction in both endo and epicardial potentials. Although the precise mechanisms of changes in ventricular potentials remains unclear, such changes, nevertheless, may indicate, in clinical circumstances, an acute shift in left ventricular volume.

摘要

在对麻醉开胸犬经输血使左心室尺寸发生急性变化期间,记录其左、右心室内膜(内膜电位)和外膜(外膜电位)的单极电位。使用一对植入式超声晶体详细记录左心室前后径的变化。当直径平均增加11%时,左心室内膜电位降低28%,左心室外膜电位降低15%。右心室内膜电位和外膜电位同时降低相似幅度(-36%)。在所研究的范围内,电位与左心室直径之间呈负线性关系,且不受血细胞比容变化的影响。未观察到内膜电位和外膜电位变化之间的反比关系。提示直接从心内膜或心外膜记录的电位主要反映电极紧邻组织的电活动。据推测,心室容积增加通过使心室壁伸展和变薄,减少了电极信号中所代表的有效组织质量,从而导致内膜和外膜电位均降低。尽管心室电位变化的确切机制尚不清楚,但在临床情况下,这种变化可能提示左心室容积的急性改变。

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