Endo H, Shiraishi H, Yanagisawa M
Department of Pediatrics, Jichi Medical School, Tochigi, Japan.
Cardiovasc Drugs Ther. 1994 Feb;8(1):161-6. doi: 10.1007/BF00877105.
Hydralazine was administered at cardiac catheterization to eight children with a ventricular septal defect (age: 2.2-8.8 years), and the extent of afterload reduction was determined using aortic input impedance and wall stress. The pulmonary to systemic blood flow ratio decreased from 2.2 +/- 0.8 to 1.8 +/- 0.4 (p < 0.05) and the pulmonary systemic resistance ratio increased from 0.11 +/- 0.08 to 0.13 +/- 0.10 (p < 0.05) after hydralazine administration. Hydralazine reduced mean aortic pressure and the amplitude of the late systolic peak of the aortic pressure wave. Peak flow velocity in the descending aorta increased from 62 +/- 14 to 81 +/- 24 cm/sec (p < 0.05). Peripheral resistance decreased significantly from 13.3 +/- 5.9 to 6.6 +/- 3.7 10(3) dyn sec/cm3 (p < 0.05). The modulus of the first harmonic, indicating pulse wave reflection, decreased from 1196 +/- 575 to 815 +/- 382 dyn sec/cm3 (p < 0.05). The characteristic impedance, indicating aortic stiffness, did not change. End-systolic wall stress decreased significantly from 54.4 +/- 16.7 to 34.8 +/- 10.2 g/cm2 (p < 0.01). Hydralazine acutely achieved afterload reduction by reducing both peripheral resistance and pulse wave reflection, and increased stroke volume.
在心脏导管插入术期间，给8名室间隔缺损患儿（年龄2.2 - 8.8岁）使用了肼屈嗪，并利用主动脉输入阻抗和壁应力来确定后负荷降低的程度。使用肼屈嗪后，肺循环与体循环血流量之比从2.2±0.8降至1.8±0.4（p<0.05），肺循环与体循环阻力之比从0.11±0.08升至0.13±0.10（p<0.05）。肼屈嗪降低了平均主动脉压以及主动脉压力波收缩晚期峰值的幅度。降主动脉的峰值流速从62±14厘米/秒增至81±24厘米/秒（p<0.05）。外周阻力从13.3±5.9显著降至6.6±3.7×10³达因·秒/厘米³（p<0.05）。表明脉搏波反射的一次谐波模量从1196±575降至815±382达因·秒/厘米³（p<0.05）。表明主动脉僵硬度的特性阻抗未发生变化。收缩末期壁应力从54.4±16.7显著降至34.8±10.2克/平方厘米（p<0.01）。肼屈嗪通过降低外周阻力和脉搏波反射，急性实现了后负荷降低，并增加了心搏量。
