Slutsky R, Higgins C, Costello D, Hooper W, LeWinter M M
Am Heart J. 1983 Jul;106(1 Pt 1):107-13. doi: 10.1016/0002-8703(83)90447-7.
Elevation in left ventricular (LV) end-diastolic pressure (EDP) after contrast ventriculography (CV) has been proposed as a form of stress intervention in patients with coronary artery disease (CAD). The mechanism of this change has not been delineated. Accordingly, we performed two studies in CAD patients. In study 1 (n = 10), CV was repeated 3 minutes after an initial study. LVEDP rose from 14.9 +/- 6.6 mm Hg prior to the first ventriculogram to 26.9 +/- 10.8 mm Hg 3 minutes after the first ventriculogram (p less than 0.05) and immediately prior to the repeat CV (performed to evaluate the changes in volume produced by the first ventriculogram). In four patients with LV micromanometer pressures, the entire diastolic pressure-volume relation was shifted upward. LV ejection fraction (EF) and end-diastolic volume (EDV), peak LV pressure, and peripheral vascular resistance were unchanged at the time of repeat CV, and there was no correlation between the change in EDP and any of these variables. In study 2 (n = 6), gated radionuclide angiography was performed prior to and at minutes 2 to 7 after CV as were measurements of LV and right ventricular (RV) pressures. While both LV and RV EDP rose following contrast ventriculography, LV and RV EDV and EF were unchanged. We conclude that alterations in LVEDP after CV are unrelated to changes in LV or RV EDV and are most likely mediated by a decrease in myocardial compliance.
对比心室造影（CV）后左心室（LV）舒张末期压力（EDP）升高已被提议作为冠心病（CAD）患者的一种应激干预形式。这种变化的机制尚未阐明。因此，我们对CAD患者进行了两项研究。在研究1（n = 10）中，在首次研究后3分钟重复进行CV。左心室舒张末期压力从首次心室造影前的14.9±6.6 mmHg升至首次心室造影后3分钟时的26.9±10.8 mmHg（p<0.05），并在重复CV（用于评估首次心室造影产生的容量变化）前即刻出现。在4名进行左心室微测压的患者中，整个舒张压-容量关系向上移位。重复CV时，左心室射血分数（EF）、舒张末期容积（EDV）、左心室峰值压力和外周血管阻力均未改变，且EDP的变化与这些变量中的任何一个均无相关性。在研究2（n = 6）中，在CV前及CV后2至7分钟进行门控放射性核素血管造影，并测量左心室和右心室（RV）压力。虽然对比心室造影后左心室和右心室EDP均升高，但左心室和右心室EDV及EF均未改变。我们得出结论，CV后左心室舒张末期压力的改变与左心室或右心室EDV的变化无关，最可能是由心肌顺应性降低介导的。
