Sasaki T, Matsuzaki M, Takahashi Y, Toma Y, Uchida T, Ogawa H, Naito H, Matsuda Y, Kumada T, Kusukawa R
J Cardiogr. 1981 Jun;11(2):543-51.
Since myocardial pump function is affected by preload or afterload, it is difficult to assess left ventricular (LV) contractility independently from these in clinical cardiology. In this study, we performed inotropic intervention by isoproterenol or propranolol, and changed afterload by angiotensin or nitroprusside, to estimate the usefulness of peak systolic pressure/end-systolic volume index (PSP/ESVI) as a parameter of LV contractility. The data were obtained by cuff method or catheter-tip manometer and echocardiography. We calculated PSP/ESVI in various heart diseases, and results were analyzed for a significant change using the t test. Ejection fraction, mean VCF (mVCF) were calculated simultaneously, and compared with PSP/ESVI. The results were as follows: 1) PSP/ESVI ratio significantly reflected inotropic intervention with isoproterenol and propranolol. 2) PSP/ESVI ratio was less affected by the change of peak systolic pressure than EF or mVCF. 3) There was a significant difference in PSP/ESVI among congestive cardiomyopathy, valvular heart diseases and normal controls. 4) There was also a significant difference in PSP/ESVI between patients of NYHA I and those of NYHA II--IV. 5) PSP/ESVI ratio, measured by non-invasive method, was thought to be a useful parameter to assess LV contractility.
由于心肌泵功能受前负荷或后负荷的影响,在临床心脏病学中很难独立于这些因素来评估左心室(LV)收缩力。在本研究中,我们通过异丙肾上腺素或普萘洛尔进行变力干预,并通过血管紧张素或硝普钠改变后负荷,以评估收缩压峰值/收缩末期容积指数(PSP/ESVI)作为左心室收缩力参数的有用性。数据通过袖带法或导管尖端压力计以及超声心动图获得。我们计算了各种心脏病中的PSP/ESVI,并使用t检验分析结果是否有显著变化。同时计算射血分数、平均圆周纤维缩短速度(mVCF),并与PSP/ESVI进行比较。结果如下:1)PSP/ESVI比值显著反映了异丙肾上腺素和普萘洛尔的变力干预。2)PSP/ESVI比值受收缩压峰值变化的影响小于射血分数或mVCF。3)充血性心肌病、瓣膜性心脏病和正常对照组之间的PSP/ESVI存在显著差异。4)纽约心脏病协会(NYHA)I级患者和NYHA II-IV级患者之间的PSP/ESVI也存在显著差异。5)通过非侵入性方法测量的PSP/ESVI比值被认为是评估左心室收缩力的有用参数。