Hébert J L, Lecarpentier Y, Zamani K, Coirault C, Daccache G, Chemla D
Service de Physiologie Cardio-Respiratoire, Université de Paris XI, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Am J Cardiol. 1995 Aug 1;76(4):301-6. doi: 10.1016/s0002-9149(99)80086-1.
It has recently been suggested that mean arterial pressure provides a reliable estimate of dicrotic notch pressure in infants and children. The aim of the present study was twofold: (1) to investigate the relation existing between aortic dicrotic notch pressure and both the steady and pulsed component of aortic pressure in adults (i.e., mean and pulse aortic pressures, respectively); and (2) to evaluate mean aortic pressure as an estimate of aortic dicrotic notch pressure. High-fidelity pressure recordings were obtained at the aortic root level in 17 men (52 +/- 13 years). Pressure data were analyzed at rest over 10 consecutive beats in each patient, and, in 6 patients, during the Valsalva maneuver (over 22 to 50 consecutive beats). At rest, dicrotic notch pressure was greater than mean pressure (109.0 +/- 17.9 vs 99.6 +/- 12.5 mm Hg, p = 0.0001). Dicrotic notch pressure was positively related to mean pressure (r = 0.93) and to pulse pressure (r' = 0.77), but not to patient's heart rate, cardiac output, or total estimated arterial compliance. There was a spontaneous beat-to-beat relation between dicrotic notch and mean pressures (1) at rest in 16 of 17 patients (mean r = 0.85), and (2) in all patients undergoing the Valsalva maneuver (mean r = 0.97). During the maneuver, intravascular mean pressure ranged from 59 to 171 mm Hg. Dicrotic notch pressure was positively related to mean pressure (r = 0.98) and to pulse pressure (r' = 0.44). Both at rest and during the Valsalva maneuver, mean pressure underestimated dicrotic notch pressure, and the higher the dicrotic notch pressure, the more negative the percent error (each p = 0.0001). In conclusion, aortic dicrotic notch pressure was mainly related to the steady component of aortic pressure. The mean aortic pressure slightly but significantly underestimated aortic dicrotic notch pressure, and thus should be used with greater caution in adults than in young patients as an estimate of end-systolic pressure.
最近有人提出，平均动脉压可可靠地估算婴幼儿的重搏波切迹压。本研究的目的有两个：（1）研究成人主动脉重搏波切迹压与主动脉压力的稳定成分和搏动成分之间的关系（分别为平均主动脉压和脉压）；（2）评估平均主动脉压作为主动脉重搏波切迹压的估算值。在17名男性（52±13岁）的主动脉根部水平进行了高保真压力记录。对每位患者静息状态下连续10次心跳的压力数据进行分析，6名患者在瓦尔萨尔瓦动作期间（连续22至50次心跳）进行分析。静息时，重搏波切迹压高于平均压（10
