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左心室卸载降低等容右心室压力下降速率。

Left ventricular unloading decreases rate of isovolumic right ventricular pressure decline.

作者信息

Brown C D, Chow E, Farrar D J

机构信息

Department of Cardiac Surgery, California Pacific Medical Center, San Francisco 94115.

出版信息

Am J Physiol. 1993 Nov;265(5 Pt 2):H1663-9. doi: 10.1152/ajpheart.1993.265.5.H1663.

Abstract

To determine whether direct ventricular interaction affects right ventricular (RV) relaxation, we compared the minimum rate of change of RV pressure (dP/dtmin) and the time constant, tau, of isovolumic RV pressure decline in open-chest, anesthetized pigs following a normal left ventricular (LV) contraction and an acutely unloaded LV contraction. Rapid removal of blood via the LV apex into a prosthetic ventricle during a single systole decreased the LV pressure-time integral 68.3% and peak systolic pressure 49.9% without changing RV end-diastolic conditions. Micromanometers measured ventricular chamber pressures during single RV isovolumic beats, which were produced by transient pulmonary artery occlusion in both the control and the LV-unloaded states. When the LV was unloaded, RV tau rose significantly from 41.7 +/- (SD) 7.1 to 49.8 +/- 9.4 ms, P < 0.005 (pericardium intact) and 42.9 +/- 10.8 to 51.8 +/- 13.9 ms, P < 0.005 (pericardium opened). Simultaneously, RV dP/dtmin decreased from -400.5 +/- 136.6 to -288.3 +/- 46.8 mmHg/s, P = 0.14 (pericardium intact), and -342.4 +/- 104.2 to -241.2 +/- 118.9 mmHg/s, P < 0.01 (pericardium opened). These data indicate that LV systolic unloading decreases the rate of RV relaxation. We conclude that RV relaxation is influenced by direct anatomic ventricular interaction.

摘要

为了确定心室间直接相互作用是否会影响右心室(RV)舒张功能,我们比较了开胸麻醉猪在正常左心室(LV)收缩和急性左心室负荷减轻收缩后,右心室压力的最小变化率(dP/dtmin)以及等容性右心室压力下降的时间常数tau。在单次心动周期中,通过左心室心尖快速将血液引流至人工心室,使左心室压力-时间积分降低68.3%,收缩压峰值降低49.9%,而不改变右心室舒张末期状态。在对照和左心室卸载状态下,通过短暂阻断肺动脉产生单次右心室等容搏动,用微测压计测量心室腔压力。当左心室卸载时,右心室tau显著升高,从41.7±(标准差)7.1毫秒升至49.8±9.4毫秒,P<0.005(心包完整),从42.9±10.8毫秒升至51.8±13.9毫秒,P<0.005(心包打开)。同时,右心室dP/dtmin从-400.5±136.6降至-288.3±46.8mmHg/s,P = 0.14(心包完整),从-342.4±104.2降至-241.2±118.9mmHg/s,P<0.01(心包打开)。这些数据表明左心室收缩期卸载会降低右心室舒张速率。我们得出结论,右心室舒张受心室间直接解剖学相互作用的影响。

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