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[起搏诱导型心绞痛中左心室的功能]

[Function of the left ventricle in pacing-induced angina pectoris].

作者信息

Pech H J, Parsi R A, Porstmann W, Heublein B

出版信息

Z Gesamte Inn Med. 1980 Nov 1;35(21):785-92.

PMID:7467599
Abstract

In 48 patients with angiographically ascertained coronary arteriosclerosis and 15 patients with unconspicuous cardiac findings a complete pressure-flow-volume-analysis of the left ventricle in rest and under artificial atrial tachycardia (atrial pacing) was carried out. In 26 patients with coronary arteriosclerosis a typical angina pectoris could be induced, however, in this group a specific constellation of the findings of the initial values was not present. Under influence of angina pectoris an increase of the disturbances of the regional contraction, connected with a significant decrease of the ejection fraction and of the isovolumetric contractibility parameter Vpm. Apart from this a significant increase of the enddiastolic ventricular pressure and of the quotient deltaP/deltaV in the diastole as a sequel of a decreased distensibility of the ventricle was found. In one part of the patients as an expression of the efficacy of the Frank-Starling-mechanism also the enddiastolic volume increased. Altogether a broad spectre of the functional changes was the result, the direction and degree of severity of which could not be foreseen according to the adequate findings in rest.

摘要

对48例经血管造影确诊为冠状动脉硬化的患者以及15例心脏检查无异常发现的患者,进行了静息状态下和人工房性心动过速(心房起搏)时左心室完整的压力-流量-容积分析。在26例冠状动脉硬化患者中可诱发典型心绞痛,但该组初始值的特定表现并不存在。在心绞痛的影响下,局部收缩紊乱增加,同时射血分数和等容收缩性参数Vpm显著降低。除此之外,由于心室扩张性降低,舒张末期心室压力和舒张期ΔP/ΔV商显著增加。在一部分患者中,舒张末期容积也增加,这是Frank-Starling机制作用的表现。总之,出现了广泛的功能变化,其方向和严重程度无法根据静息时的适当检查结果预测。

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