Bussmann W D, Heeger J, Kaltenbach M
Z Kardiol. 1977 Dec;66(12):696-705.
The function of the left ventricle is important for the success of surgery. To differentiate between normal and abnormal ventricular function, the contractile and relaxation reserve was measured. In 19 patients, 10 with mitral and 9 with aortic valve disease, max dP/dt and min dP/dt were measured at rest and during exercise (ergometer). Max dP/dt increased in 7 patients above 3200 mm Hg/s and dP/dt/P above 60 s-1 (normal contractile reserve). Only 3 of these patients reached a normal increment of relaxation velocity (min dP/dt above 2400 mm Hg/s). In 12 patients the contractile and relaxation reserve was decreased. All patients with mitral stenosis had abnormal relaxation reserve despite normal contractile function in 4 cases. Left ventricular enddiastolic pressure did not correlate well with myocardial dysfunction. Isovolumic contractility during exercise was decreased in patients with aortic valve disease. Enddiastolic pressure increased from 18 +- 8 to 22 +- 14 mm Hg during exercise.
左心室功能对于手术成功至关重要。为区分正常和异常的心室功能，对收缩储备和舒张储备进行了测量。在19例患者中，10例患有二尖瓣疾病，9例患有主动脉瓣疾病，在静息状态和运动期间（测力计）测量了最大dp/dt和最小dp/dt。7例患者的最大dp/dt增加至3200mmHg/s以上，dp/dt/P增加至60s-1以上（正常收缩储备）。这些患者中只有3例达到了正常的舒张速度增加（最小dp/dt高于2400mmHg/s）。12例患者的收缩储备和舒张储备降低。所有二尖瓣狭窄患者尽管4例收缩功能正常，但舒张储备均异常。左心室舒张末期压力与心肌功能障碍的相关性不佳。主动脉瓣疾病患者运动期间的等容收缩力降低。运动期间舒张末期压力从18±8mmHg增加至22±14mmHg。
