Regen D M, Denton P K, Howe W C, Taylor L K, Hansen D E
Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN 37232.
Heart Vessels. 1994;9(3):155-66. doi: 10.1007/BF01745241.
The peak pressure which a chamber would develop in isovolumic contraction at end-diastolic distention (peak source pressure) is an expression of contractile vigor and a determinant of systolic performance. One can predict source pressure of an ejecting beat by fitting its isovolumic phases with a model isovolumic-wave function. Characteristics of the left-ventricular isovolumic pressure wave (amplitude, duration, shape) were studied in isolated, perfused, artificially loaded dog hearts, where strictly isovolumic conditions could be obtained over a wide range of cavity volumes at constant heart rate and approximately constant contractile state. The characterization involved two steps: (1) beginning and ending points were identified by a transition-locating algorithm, and (2) Fourier analysis was performed on points in between. The amplitude of the isovolumic pressure wave increased with cavity volume as expected, the duration of contraction increased with cavity volume, and the shape of the wave (normalized Fourier coefficients) depended slightly on the cavity volume. Duration of contraction declined slightly with increasing heart rate, but the shape of the isovolumic pressure wave was independent of heart rate. The mean shape was similar to that found in dog hearts subjected to one-beat aortic-root clamping in vivo-the wave being less sharply peaked than a cosine wave and tilted to the left because relaxation was slower than contraction. When ejecting beat duration declined linearly with increasing ejection fraction. This relation could be used to predict the duration of the isovolumic beat corresponding to the duration of an ejecting beat. Source pressure could then be predicted by fitting a model isovolumic wave of predicted duration to the isovolumic contraction phase of the ejecting beat. In 270 comparisons, the ratio of predicted peak source pressure to observed peak source pressure was 1.04 +/- 0.10 (SD). This method provides a reasonably accurate prediction of an important determinant of systolic performance.
在舒张末期扩张时,心腔在等容收缩期所产生的峰值压力(峰值源压力)是收缩力的一种表现形式,也是收缩期功能的一个决定因素。通过将其等容相拟合到一个模型等容波函数中,可以预测射血搏动的源压力。在离体、灌注、人工加载的犬心脏中研究了左心室等容压力波的特征(振幅、持续时间、形状),在这种情况下,在恒定心率和大致恒定的收缩状态下,可在很宽的腔室容积范围内获得严格的等容条件。该表征包括两个步骤:(1) 通过转换定位算法确定起点和终点,(2) 对其间的点进行傅里叶分析。等容压力波的振幅如预期的那样随腔室容积增加,收缩持续时间随腔室容积增加,并且波的形状(归一化傅里叶系数)略微依赖于腔室容积。收缩持续时间随心率增加略有下降,但等容压力波的形状与心率无关。平均形状与在体内接受单次主动脉根部夹闭的犬心脏中发现的形状相似——该波的峰值不如余弦波尖锐,并且由于舒张比收缩慢而向左倾斜。当射血搏动持续时间随射血分数增加呈线性下降时。这种关系可用于预测与射血搏动持续时间相对应的等容搏动的持续时间。然后,通过将预测持续时间的模型等容波拟合到射血搏动的等容收缩期,可以预测源压力。在270次比较中,预测的峰值源压力与观察到的峰值源压力之比为1.04±0.10(标准差)。该方法为收缩期功能的一个重要决定因素提供了合理准确的预测。