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在无心包的犬慢性右心室压力超负荷前后,右心室压力对舒张末期左心室压力-容积关系的影响。

Effect of right ventricular pressure on the end-diastolic left ventricular pressure-volume relationship before and after chronic right ventricular pressure overload in dogs without pericardia.

作者信息

Little W C, Badke F R, O'Rourke R A

出版信息

Circ Res. 1984 Jun;54(6):719-30. doi: 10.1161/01.res.54.6.719.

Abstract

We studied the effect of chronic right ventricular pressure overload on diastolic ventricular interdependence in dogs without pericardia, instrumented to measure left ventricular pressure, right ventricular pressure, and 3 left ventricular dimensions. We studied 12 dogs before (control) and nine dogs after 6 weeks of pulmonary artery constriction producing systolic right ventricular pressure greater than or equal to 70 mm Hg. Compared to control, following pulmonary artery band there was greater (P less than 0.01) interventricular septal mass (53 +/- 15 vs. 35 +/- 7 mg, mean +/- SD), thickness (15 +/- 2 vs. 10 +/- 1 mm), and ratio of the surface area of the interventricular septal to total left ventricular surface area (0.38 +/- 0.03 vs. 0.33 +/- 0.02), but unchanged left ventricular free wall mass (81 +/- 12 vs. 84 +/- 14 mg) and thickness (11 +/- 2 vs. 11 +/- 2 mm). End-diastolic right and left ventricular pressures and left ventricular volume were varied by vena cava and pulmonary artery occlusions and releases. Volume was calculated as an ellipsoid and the data in each dog fit to: left ventricular pressure = a0 + a1V + a2V2 + a3V3 + a4V4 + bPRV, r greater than or equal to 0.91 in each dog. During control, b was similar, whether calculated from both pulmonary artery and vena cava occlusions (0.47 +/- 0.09) or from vena cava occlusions alone (0.43 +/- 0.11), and was greater than the ratio of the interventricular septal surface area to left ventricular surface area (0.33 +/- 0.02, P less than 0.05). Following the pulmonary artery band, b decreased to 0.21 +/- 0.10 (P less than 0.05) and was less than the ratio of interventricular septal surface area to the left ventricular surface area which increased to 0.38 +/- 0.03 (P less than 0.05). We conclude that the effect of alterations in right ventricular pressure on the end-diastolic left ventricular pressure volume relationship, independent of the pericardium, is reduced following the pulmonary artery band that produces interventricular septal hypertrophy. These results are consistent with the hypothesis that the effect of alterations of right ventricular pressure on the diastolic left ventricular pressure-volume relationship depends on the relative elastance of the interventricular septum and left ventricular free wall, and not simply on the ratio of the interventricular septal surface area to the left ventricular surface area.

摘要

我们研究了慢性右心室压力超负荷对无心包犬舒张期心室相互依赖的影响,这些犬通过仪器测量左心室压力、右心室压力和3个左心室维度。我们在肺动脉缩窄6周前(对照组)研究了12只犬,在肺动脉缩窄后研究了9只犬,此时收缩期右心室压力大于或等于70 mmHg。与对照组相比,肺动脉束带后室间隔质量更大(P<0.01)(53±15 vs. 35±7 mg,平均值±标准差)、厚度更大(15±2 vs. 10±1 mm)以及室间隔表面积与左心室总表面积之比更大(0.38±0.03 vs. 0.33±0.02),但左心室游离壁质量(81±12 vs. 84±14 mg)和厚度(11±2 vs. 11±2 mm)未改变。通过腔静脉和肺动脉的阻断与松开改变舒张末期右心室和左心室压力以及左心室容积。容积按椭圆体计算,每只犬的数据拟合为:左心室压力 = a0 + a1V + a2V2 + a3V3 + a4V4 + bPRV,每只犬的r≥0.91。在对照组期间,无论从肺动脉和腔静脉阻断两者计算(0.47±0.09)还是仅从腔静脉阻断计算(0.43±0.11),b都相似,且大于室间隔表面积与左心室表面积之比(0.33±0.02,P<0.05)。肺动脉束带后,b降至0.21±0.10(P<0.05),且小于室间隔表面积与左心室表面积之比,该比值增至0.38±0.03(P<0.05)。我们得出结论,在产生室间隔肥厚的肺动脉束带后,右心室压力改变对舒张末期左心室压力-容积关系的影响(独立于心包)减小。这些结果与以下假设一致,即右心室压力改变对舒张期左心室压力-容积关系的影响取决于室间隔和左心室游离壁的相对弹性,而不仅仅取决于室间隔表面积与左心室表面积之比。

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