Mitsuhata H, Hasome N, Saitoh J, Takeuchi H, Horiguchi Y, Shimizu R
Department of Anesthesiology, Jichi Medical School, Tochigi, Japan.
Acta Anaesthesiol Scand. 1995 Aug;39(6):791-6. doi: 10.1111/j.1399-6576.1995.tb04172.x.
Depressed left ventricular (LV) systolic function remains controversial in patients with anaphylaxis and anaphylactic animal models. However, LV diastolic function has not yet been investigated in either patients or animal models. Therefore, we assessed LV diastolic and systolic function in IgE-mediated anaphylaxis in dogs. Seven dogs sensitized to Ascaris suum antigen were studied. An aqueous extract of Ascaris suum antigen was administered over 30 s into the systemic circulation to induce anaphylaxis. To assess LV function, the time constant of the fall of isovolumic LV pressure (T), as an index of LV diastolic function, and the maximum rate of rise of LV pressure (dP/dtmax), as an index of LV systolic function, were measured for a period of 120 min after antigen challenge. T was prolonged during the period of 5 to 15 min; however, changes in T were not significantly different from prechallenge values. LV d}/dtmax significantly decreased to 0.49 +/- 0.12 times the prechallenge value 5 min after antigen challenge, and significantly increased during the period from 30 to 120 min. However, these changes in dP/dtmax almost paralleled the changes in LV end-diastolic pressure, indicating that left ventricular systolic function was relatively well preserved. In conclusion, LV diastolic function, i.e., isovolumic relaxation, is little impaired in anaphylaxis, and LV systolic function is relatively well preserved during the early stage following the onset of anaphylaxis.
在过敏反应患者及过敏性动物模型中,左心室(LV)收缩功能降低仍存在争议。然而,无论是在患者还是动物模型中,LV舒张功能尚未得到研究。因此,我们评估了犬类IgE介导的过敏反应中的LV舒张和收缩功能。研究了7只对猪蛔虫抗原致敏的犬。将猪蛔虫抗原水提取物在30秒内注入体循环以诱导过敏反应。为评估LV功能,在抗原激发后120分钟内,测量等容LV压力下降的时间常数(T)作为LV舒张功能指标,以及LV压力上升的最大速率(dP/dtmax)作为LV收缩功能指标。T在5至15分钟期间延长;然而,T的变化与激发前值无显著差异。抗原激发后5分钟,LV dP/dtmax显著降至激发前值的0.49±0.12倍,并在30至120分钟期间显著增加。然而,dP/dtmax的这些变化几乎与LV舒张末期压力的变化平行,表明左心室收缩功能相对保持良好。总之,在过敏反应中,LV舒张功能即等容舒张几乎未受损,且在过敏反应发作后的早期阶段,LV收缩功能相对保持良好。