Suga H
Department of Physiology II, Okayama University Medical School, Japan.
Jpn Heart J. 1994 May;35(3):263-80. doi: 10.1536/ihj.35.263.
Viewing canine left ventricular performance through the pressure-volume (P-V) window, I proposed a new index of ventricular contractility (Emax: end-systolic P-V ratio or maximum elastance) in my doctoral thesis at the University of Tokyo in 1969. After I joined Dr. Kiichi Sagawa (deceased in 1989) at Johns Hopkins University, we firmly established the Emax concept during 1971-1978. The concept was extended to derive the systolic P-V area (PVA) as a new measure of the total mechanical energy generated by ventricular contraction in 1978. Experiments have revealed that PVA closely correlates with cardiac oxygen (O2) consumption (VO2) under various loading conditions at a constant Emax, the VO2-PVA relation changes its elevation with Emax, and the O2 costs of PVA and Emax characterize the mechanoenergetics of cardiac contraction under various normal and abnormal conditions in an innovative manner (Suga: Physiol Rev 70: 247-277, 1990). Emax and PVA can also evaluate the ventriculo-arterial hydraulic and energetic matching in normal and failing hearts. Emax and PVA have thus widely opened the P-V window to the extent that human and animal normal and failing cardiac performance can be characterized in a physiologically sound manner.
1969年，在东京大学攻读博士学位期间，我通过压力-容积（P-V）窗观察犬类左心室功能，提出了一种新的心室收缩性指标（Emax：收缩末期P-V比值或最大弹性）。1971年我加入约翰·霍普金斯大学的佐川吉一博士（1989年去世）团队后，我们在1971年至1978年期间牢固确立了Emax概念。1978年，该概念得到扩展，由此推导出收缩期P-V面积（PVA），作为心室收缩产生的总机械能的一种新度量。实验表明，在恒定Emax下，各种负荷条件下PVA与心脏氧（O2）消耗（VO2）密切相关，VO2-PVA关系随Emax改变其斜率，并且PVA和Emax的氧耗以一种创新的方式表征了各种正常和异常条件下心脏收缩的机械能量学（须贺：《生理学评论》70：247 - 277，1990）。Emax和PVA还可以评估正常和衰竭心脏中的心室-动脉液压和能量匹配。Emax和PVA因此广泛打开了P-V窗，以至于能够以生理合理的方式表征人类和动物正常及衰竭的心脏功能。
