Sabbah H N, Khaja F, Anbe D T, Stein P D
Cathet Cardiovasc Diagn. 1978;4(1):53-62. doi: 10.1002/ccd.1810040108.
Sudden momentary fluctuations of left ventricular, aortic, right ventricular, and pulmonary arterial pressure were noted during isovolumic relaxation of the respective ventricles. The presence of such transients raised questions related to their meaning and significance. The purpose of this report is to emphasize the nonartifactural nature of these pressure transients and to describe their origin and significance in the cardiac cycle. Pressure transients were observed in 31 of 32 patients with normal aortic valves, and in 17 patients with normal pulmonary valves in whom right-sided measurements were made. Such transients, however, were absent on the left ventricular and aortic pressure recordings of three patients with calcific aortic stenosis. These sudden changes in pressure are indicative of momentary compressions and rarefactions of the blood that occur within the ventricles and their respective arterial chambers. Whenever present, pressure transients were noted to occur coincident with the major aortic or pulmonary components of the second sound. Since intraaterial sound pressure is derived from the pressure signal by litering the low frequencies and amplifying the high frequencies, one can deduce that intraarterial sound pressure is in fact a representation of these pressure changes. The recognition of these pressure transients on an otherwise smooth ventricular, aortic, or pulmonary arterial pressure places in proper perspective their role in the production of the second heart sound.
在各心室等容舒张期，观察到左心室、主动脉、右心室和肺动脉压力的突然短暂波动。这些瞬态现象的存在引发了与其意义和重要性相关的问题。本报告的目的是强调这些压力瞬态并非人为造成，并描述其在心动周期中的起源和意义。在32例主动脉瓣正常的患者中，有31例观察到压力瞬态；在17例进行右侧测量且肺动脉瓣正常的患者中也观察到了压力瞬态。然而，在3例钙化性主动脉瓣狭窄患者的左心室和主动脉压力记录中未出现这种瞬态现象。这些压力的突然变化表明心室内及其各自动脉腔内的血液出现了瞬间压缩和稀疏。只要出现压力瞬态，就会发现其与第二心音的主要主动脉或肺动脉成分同时出现。由于动脉内声压是通过滤除低频并放大高频从压力信号中得出的，因此可以推断动脉内声压实际上是这些压力变化的一种表现。在原本平滑的心室、主动脉或肺动脉压力曲线上识别出这些压力瞬态，能正确看待它们在第二心音产生中的作用。
