Boettcher D H, Vatner S F, Heyndrickx G R, Braunwald E
Am J Physiol. 1978 Apr;234(4):H338-45. doi: 10.1152/ajpheart.1978.234.4.H338.
The extent to which an increase in preload increases left ventricular (LV) end-diastolic (ED) diameter (D) was studied in seven conscious dogs instrumented with ultrasonic D transducers and miniature LV pressure (P) gauges. Preload was elevated by three techniques: 1) volume loading with saline infusion, 2) induction of global myocardial ischemia by constricting the left main coronary artery, and 3) infusion of methoxamine. These three interventions increased LVEDP to over 30 mmHg from a control of 10 +/- 1 mmHg. With volume loading, LVEDD rose by only 1.55 +/- 0.39 mm from a control of 44.08 +/- 1.08 mm; with ischemia LVEDD rose by only .96 +/- .29 mm from a control of 42.55 +/- 2.18 mm, while with methoxamine LVEDD rose by only 1.34 +/- 0.38 mm from a control of 43.89 +/- 2.07 mm. In contrast, in the open-chest, anesthetized dog, LVEDD was greatly reduced and volume expansion resulted in a profound increase in LVEDD. Thus, the Frank-Starling mechanism is not an important controlling mechanism in the normal, reclining, conscious animal, since LVEDD appears to be near maximal at rest and does not increase substantially despite striking increases in LVEDP.
在七只清醒犬身上进行了研究,这些犬安装了超声心动图直径(D)换能器和微型左心室压力(P)测量仪,以探究前负荷增加对左心室(LV)舒张末期(ED)直径(D)的影响程度。通过三种技术提高前负荷:1)静脉输注生理盐水进行容量负荷;2)通过结扎左冠状动脉主干诱导全心心肌缺血;3)静脉输注甲氧明。这三种干预措施使左心室舒张末期压力(LVEDP)从对照组的10±1 mmHg升高至超过30 mmHg。容量负荷时,左心室舒张末期直径(LVEDD)仅从对照组的44.08±1.08 mm增加了1.55±0.39 mm;缺血时,LVEDD仅从对照组的42.55±2.18 mm增加了0.96±0.29 mm,而甲氧明使LVEDD仅从对照组的43.89±2.07 mm增加了1.34±0.38 mm。相比之下,在开胸麻醉犬中,LVEDD显著减小,容量扩张导致LVEDD显著增加。因此,在正常、仰卧、清醒的动物中,Frank-Starling机制并非重要的控制机制,因为LVEDD在静息时似乎已接近最大值,尽管LVEDP显著增加,LVEDD却并未大幅增加。