Koiwa Y, Nunokawa T, Ishide N, Isoyama S, Kitaoka S, Tamaki K, Satoh S, Suzuki H, Shimizu Y, Kakuta Y, Ino-Oka E, Takishima T
Circulation. 1980 Oct;62(4):745-55. doi: 10.1161/01.cir.62.4.745.
WE quantitatively analyzed the effect of graded left anterior descending and septal coronary flow (LAD + septal flow) reduction on left ventricular function with a left ventricular end-diastolic pressure (LVEDP) of 6 mm Hg and 12 mm Hg. We used an isolated, ejecting, canine heart preparation ( n = 8), the coronary flow of which could be controlled independently of the aortic pressure. We kept the other hemodynamic variables - heart rate, left circumflex coronary flow, right coronary flow and aortic input impendance - constant within their normal physiologic range. We considered this reduction in LAD + septal flow to be analogous to that of the most frequent lesion in ischemic heart disease. There was no plateau in the left ventricular work caused by this reduction of the regional coronary flow. Therefore, the plateau commonly reported in previous studies may be partially a result of the compensatory elevation of LVEDP, which is necessary to maintain the left ventricular work.
我们定量分析了在左心室舒张末期压力（LVEDP）为6毫米汞柱和12毫米汞柱的情况下，分级减少左前降支和间隔冠状动脉血流（LAD + 间隔血流）对左心室功能的影响。我们使用了一种离体的、有射血功能的犬心标本（n = 8），其冠状动脉血流可独立于主动脉压力进行控制。我们将其他血流动力学变量——心率、左旋支冠状动脉血流、右冠状动脉血流和主动脉输入阻抗——维持在正常生理范围内的恒定水平。我们认为LAD + 间隔血流的这种减少类似于缺血性心脏病中最常见的病变情况。这种局部冠状动脉血流减少所导致的左心室做功没有平台期。因此，先前研究中普遍报道的平台期可能部分是由于LVEDP的代偿性升高所致，而LVEDP升高对于维持左心室做功是必要的。
