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清醒犬心率改变对左心室压力-直径-速度关系的影响

Changes of left ventricular pressure-diameter-velocity relations by alterations of heart rate in conscious dogs.

作者信息

Fujiyama M, Furuta Y, Matsumura J, Tanabe A, Ohbayashi J, Utsu F, Ikeda H, Toshima H

出版信息

Jpn Circ J. 1984 Dec;48(12):1312-21. doi: 10.1253/jcj.48.1312.

DOI:10.1253/jcj.48.1312
PMID:6512941
Abstract

Changes of left ventricular (LV) pressure-diameter-velocity relations by alterations in heart rate (HR) were investigated in 6 conscious dogs, instrumented with a pair of ultrasonic crystal probe, a micromanometer in LV and pacing electrodes on the left atrium. By atrial pacing the following four stages of HR were produced: stage (S)-I 112, S-II 134, S-III 158 and S-IV 179 bpm (mean HR). These alterations in HR were repeated before and during acute pressure loadings by methoxamine infusion. LV pressure-diameter and pressure-velocity relations were evaluated by the slope value of LV peak systolic pressure (LVSP)-end-systolic diameter, E (D) max, and by the ratio of changes in mV cf (mean velocity circumferential fiber shortening) and LVSP before and during pressure loading, delta mVcf/delta LVSP, respectively. The average of E(D) max at each stage of HR was 9.45, 12.63, 12.59, 11.22 mmHg/mm, and delta mVcf/delta LVSP was -0.009, -0.006, -0.007, -0.009 circ./sec.mmHg, respectively. E(D) max increased more at S-II and S-III than at S-I, and reversely, E(D) max decreased more at S-IV than at S-II. Similarly, delta mVcf/delta LVSP increased more at S-II than at S-I and decreased more at S-IV than at S-II, while delta LVSP and delta EDD (end-diastolic diameter) were not different between stages. These changes in E(D) max and delta mVcf/delta LVSP presented the mountainous pattern effected by alterations in HR, whose changes were almost similar to that of LV peak positive dp/dt and mVcf before pressure loading. Thus, E(D) max is augmented by an increase in HR, which suggests the Bowditch-effect. Reversely, a decrease in E(D) max at a higher rate indicates a depressed inotropic state. E(D) max is dependent on HR and is a sensitive indicator of the contractility of LV.

摘要

在6只清醒犬中进行了研究,这些犬通过一对超声晶体探头、左心室内的微测压计和左心房上的起搏电极进行仪器植入,以观察心率(HR)改变对左心室(LV)压力 - 直径 - 速度关系的影响。通过心房起搏产生以下四个HR阶段:阶段(S)-I 112次/分钟,S-II 134次/分钟,S-III 158次/分钟和S-IV 179次/分钟(平均HR)。在通过静脉注射甲氧明进行急性压力负荷之前和期间,重复这些HR改变。通过左心室峰值收缩压(LVSP) - 收缩末期直径的斜率值E(D)max评估左心室压力 - 直径和压力 - 速度关系,并分别通过压力负荷之前和期间mV cf(平均圆周纤维缩短速度)和LVSP的变化率δmVcf/δLVSP进行评估。每个HR阶段的E(D)max平均值分别为9.45、12.63、12.59、11.22 mmHg/mm,δmVcf/δLVSP分别为-0.009、-0.006、-0.007、-0.009 周/秒·mmHg。E(D)max在S-II和S-III阶段比在S-I阶段增加更多,相反,E(D)max在S-IV阶段比在S-II阶段下降更多。同样,δmVcf/δLVSP在S-II阶段比在S-I阶段增加更多,在S-IV阶段比在S-II阶段下降更多,而δLVSP和δEDD(舒张末期直径)在各阶段之间没有差异。E(D)max和δmVcf/δLVSP的这些变化呈现出受HR改变影响的山峰状模式,其变化与压力负荷前左心室峰值正dp/dt和mVcf的变化几乎相似。因此,E(D)max随HR增加而增大,这提示了Bowditch效应。相反,在较高心率时E(D)max降低表明心肌收缩力状态降低。E(D)max依赖于HR,是左心室收缩性的敏感指标。

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