Mehmel H C, Stockins B, Ruffmann K, Schwarz F, Kübler W
Herz. 1981 Aug;6(4):209-16.
This investigation was undertaken to determine whether the left ventricular (LV) end-systolic pressure and end-systolic volume, as measured under clinical conditions, are linearly correlated and whether the slope of the end-systolic pressure-volume relationship (P-Ves) is a meaningful parameter in the assessment of left ventricular function. The studies were performed in twelve patients (eleven with coronary artery disease and one with congestive cardiomyopathy) during which autonomic reflex responses were minimized by propranolol (0.15 mg/kg i.v.) and atropine (1 mg i.v.). Three left ventricular angiograms (at rest, after 10 mg isosorbide dinitrate and during an infusion of 2 mg/min methoxamine) were obtained from which the three respective P-Ves data points were calculated and subjected to linear regression analysis (r greater than or equal to 0.96). The slope k of the linear P-Ves relation correlated most closely with the resting ejection fraction (EF) as an exponential function (r = 0.94). The end-systolic pressure could be interchanged with the peak systolic pressure which is more easily obtained. The theoretical end-systolic volume at end-systolic pressure = 0 (V0) was not related to the resting ejection fraction. Post-extrasystolic potentiation, resulting in an acute inotropic incrementation, shifted the P-Ves toward similar volumes and steepened its slope.
本研究旨在确定在临床条件下测量的左心室（LV）收缩末期压力和收缩末期容积是否呈线性相关，以及收缩末期压力-容积关系（P-Ves）的斜率在评估左心室功能时是否为一个有意义的参数。研究在12例患者（11例冠心病患者和1例充血性心肌病患者）中进行，在此期间通过静脉注射普萘洛尔（0.15mg/kg）和阿托品（1mg静脉注射）使自主神经反射反应降至最低。获取了三张左心室血管造影图像（静息状态、静脉注射10mg硝酸异山梨酯后以及静脉输注甲氧明2mg/min期间），从中计算出三个相应的P-Ves数据点并进行线性回归分析（r大于或等于0.96）。线性P-Ves关系的斜率k与静息射血分数（EF）作为指数函数的相关性最为密切（r = 0.94）。收缩末期压力可以与更容易获得的收缩期峰值压力互换。收缩末期压力 = 0时的理论收缩末期容积（V0）与静息射血分数无关。早搏后增强导致急性正性肌力增加，使P-Ves向相似容积偏移并使其斜率变陡。
