Kondoh Y, Sugawara M, Uchida K
Department of Cardiovascular Sciences, Tokyo Women's Medical College, Japan.
Heart Vessels. 1995;10(2):69-77. doi: 10.1007/BF01744497.
To understand the pathophysiology of diseased hearts, we devised a new regional myocardial function curve and investigated its properties. Regional work per unit volume of the myocardium (RWM) was calculated by integrating mean wall stress (sigma) with respect to the natural logarithm of the reciprocal of wall thickness [ln(1/H)] over a cardiac cycle. Regarding the end-diastolic ln(1/H) as the preload for the region of concern on the assumption that the myocardium is incompressible, we defined the relation between RWM and end-diastolic ln(1/H) as the regional myocardial function curve. In ten mongrel dogs, we measured left ventricular pressure, left ventricular internal diameter, and wall thickness with a catheter-tip micromanometer and ultrasonic dimension gauges during volume loading to obtain the regional myocardial function curve. We examined the sensitivity of the regional myocardial function curve to changes in contractile state (isoproterenol, propranolol) and changes in afterload (pressure loading by a balloon-occlusion catheter). The linear fit to the data points of the regional myocardial function curve under each condition always achieved a very good correlation coefficient (greater than 0.62). Isoproterenol increased the slope of the regional myocardial function curve from 9.7 +/- 0.9 (SEM) mJ/cm3 to 14.4 +/- 1.0 mJ/cm3 (P < 0.01), with no significant changes in the x-intercept, while propranolol decreased it to 5.6 +/- 1.2 mJ/cm3 (P < 0.01) with no significant changes in the x-intercept.(ABSTRACT TRUNCATED AT 250 WORDS)
为了解患病心脏的病理生理学,我们设计了一种新的局部心肌功能曲线并研究了其特性。心肌单位体积的局部功(RWM)通过在心动周期中对平均壁应力(σ)相对于壁厚倒数的自然对数[ln(1/H)]进行积分来计算。假设心肌不可压缩,将舒张末期的ln(1/H)视为关注区域的前负荷,我们将RWM与舒张末期ln(1/H)之间的关系定义为局部心肌功能曲线。在十只杂种狗中,我们在容量负荷期间用导管尖端微压计和超声尺寸测量仪测量左心室压力、左心室内径和壁厚,以获得局部心肌功能曲线。我们研究了局部心肌功能曲线对收缩状态变化(异丙肾上腺素、普萘洛尔)和后负荷变化(通过球囊阻塞导管进行压力负荷)的敏感性。每种情况下局部心肌功能曲线数据点的线性拟合始终获得非常好的相关系数(大于0.62)。异丙肾上腺素使局部心肌功能曲线的斜率从9.7±0.9(SEM)mJ/cm³增加到14.4±1.0 mJ/cm³(P<0.01),x轴截距无显著变化,而普萘洛尔将其降低到5.6±1.2 mJ/cm³(P<0.01),x轴截距无显著变化。(摘要截断于250字)