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心脏收缩状态对心室压力最大上升速率dP/dt max的前负荷依赖性的影响。

Influence of the contractile state of the heart of the preload dependence of the maximal rate of intraventricular pressure rise dP/dt max.

作者信息

Schmidt H D, Hoppe H

出版信息

Cardiology. 1978;63(2):112-25. doi: 10.1159/000169888.

Abstract

In canine heart-lung preparations the relation between dP/Dt max and end-diastolic pressure exhibits the steepest slope shortly after isolation of the heart. When the heart is deteriorating, the slopes of the preload dependence of right and left ventricular dP/dt max are progressively reduced, but increase again after application of calcium. The preload dependence of dP/dt max is influenced by the contractile state of the myocardium. In the right and left ventricle the change in preload dependence of dp/dt max show a linear correlation. In the individual heart the slopes of the preload dependence of dP/dt max and of aortic flow (representing ventricular function curves) change in a very similar manner with varying contractility. In 33 different isolated hearts the slopes of the preload dependence of the two parameters show a good correlation shortly after isolation of the hearts. The preload dependence of dP/dt max can not only be used for assessment of acute variations in in myocardial contractility, but appears also to be at least as reliable as the ventricular function curves for the evaluation of the basic contractile state of different hearts. This study further shows that if dP/dt max is used for evaluation of relative changes in contractility, the quantitative results are influenced by the end-diastolic pressure level chosen.

摘要

在犬心肺制备模型中,心脏分离后不久,最大dp/dt与舒张末期压力之间的关系呈现出最陡的斜率。当心脏功能恶化时,左右心室最大dp/dt的前负荷依赖性斜率逐渐降低,但在应用钙后又会增加。最大dp/dt的前负荷依赖性受心肌收缩状态的影响。在左右心室中,dp/dt最大前负荷依赖性的变化呈线性相关。在个体心脏中,最大dp/dt和主动脉血流(代表心室功能曲线)的前负荷依赖性斜率随收缩性变化的方式非常相似。在33个不同的离体心脏中,这两个参数的前负荷依赖性斜率在心脏分离后不久显示出良好的相关性。最大dp/dt的前负荷依赖性不仅可用于评估心肌收缩性的急性变化,而且在评估不同心脏的基本收缩状态时,似乎至少与心室功能曲线一样可靠。这项研究进一步表明,如果用最大dp/dt来评估收缩性的相对变化,定量结果会受到所选舒张末期压力水平的影响。

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