Bourgeois M J, Gilbert B K, Von Bernuth G, Wood E H
Circ Res. 1976 Jul;39(1):15-24. doi: 10.1161/01.res.39.1.15.
Present methods for measurement of stroke volume from the aortic pressure pulse are not suitable for beat-to-beat determinations during non-steady state conditions because these methods assume that each systolic ejection is equal to the peripheral runoff during the same beat. We have tested a new method which allows determination of an aortic pressure-volume conversion factor over a wide range of pressures during transient changes in stroke volume and infusions of vasoactive drugs in 6 dogs with chronically implanted aortic electromagnetic flowmeters. Each aortic diastolic pressure decay is approximated by an exponential the time constant of which is used to calculate the pressure loss during systole due to blood flow into the periphery. The total increment in aortic pressure due to systolic ejection, if there were no flow from the aorta during systole, then is calculated. The total systolic increment (delta PSV) is assumed to describe the pressure-volume characteristics during systole and is related to stroke volume by a constant multiplier that is derived from the indicator-dilution measurements of cardiac output. The values for beat-to-beat variations that were determined by use of the aortic electromagnetic flowmeter and by this aortic pressure pulse method were found to be within the range of measurement errors of stroke volume determined from individual aortic electromagnetic flow pulses.
目前通过主动脉压力脉搏测量每搏输出量的方法并不适用于非稳态条件下的逐搏测定,因为这些方法假定每次心脏收缩期射血都等于同一搏动期间的外周血流量。我们测试了一种新方法,该方法可在6只长期植入主动脉电磁流量计的犬类中,在每搏输出量发生瞬态变化以及注入血管活性药物期间,在很宽的压力范围内测定主动脉压力-容积转换因子。每次主动脉舒张压下降都可用一个指数函数近似表示,该指数函数的时间常数用于计算由于血液流入外周而在收缩期产生的压力损失。然后计算如果在收缩期没有血液从主动脉流出时,由于心脏收缩期射血导致的主动脉压力总增量。总收缩期增量(δPSV)被假定用于描述收缩期的压力-容积特性,并通过一个常数乘数与每搏输出量相关,该常数乘数由心输出量的指示剂稀释测量得出。通过主动脉电磁流量计和这种主动脉压力脉搏法测定的逐搏变化值,被发现在由各个主动脉电磁流量脉冲测定的每搏输出量的测量误差范围内。