Thadani U, West R O, Mathew T M, Parker J O
Am J Cardiol. 1977 May 26;39(6):776-83. doi: 10.1016/s0002-9149(77)80026-x.
To access left ventricular function and compare pulmonary capillary wedge pressure and left ventricular end-diastolic pressure in the supine and sitting positions, 20 men with angina pectoris secondary to coronary artery disease underwent hemodynamic studies at rest and during exercise in the two positions. At rest the values for cardiac index, stroke index, systolic ejection rate index and left ventricular stroke work index were lower in the sitting position; heart rate, left ventricular end-diastolic pressure and pulmonary capillary wedge pressure were similar in the two positions. All patients experienced angina during both exercise periods. At angina during supine exercise, stroke index, systolic ejection rate index and left ventricular stroke work index did not increase significantly from the resting values. In contrast, during sitting exercise, significant increases in these variables were observed. Comparison of data during exercise revealed higher values for heart rate, mean systemic pressure, cardiac index, systolic ejection rate index, left ventricular stroke work index and rate-pressure product and lower values for mean pulmonary capillary wedge pressure (20 +/- 3 versus 27 +/- 3 [mean +/- standard error of the mean] mm Hg, P is less than 0.001), and left ventricular end-diastolic pressure (24+/- 3 versus 31 +/- 3 mm Hg, P is less than 0.02) in the sitting position; stroke index and S-T segment depression were similar during the two exercise periods. Four patients had insignificant increases in left ventricular filling pressure during both exercise periods. Of the 16 patients with abnormal left ventricular filling pressure during supine exercise, only 10 had a similar response during exercise in the sitting position. There was a good correlation between left ventricular end-diastolic pressure and mean pulmonary capillary wedge pressure at rest and during exercise in the two postures.
为评估左心室功能并比较仰卧位和坐位时的肺毛细血管楔压及左心室舒张末期压力，20例因冠状动脉疾病继发心绞痛的男性患者在静息状态及两种体位下运动时接受了血流动力学研究。静息时，坐位的心脏指数、每搏指数、收缩射血率指数及左心室每搏功指数较低；两种体位下心率、左心室舒张末期压力及肺毛细血管楔压相似。所有患者在两个运动时段均出现心绞痛。仰卧位运动时发生心绞痛时，每搏指数、收缩射血率指数及左心室每搏功指数较静息值无显著增加。相比之下，坐位运动时这些变量有显著增加。运动期间数据比较显示，坐位时心率、平均体循环压力、心脏指数、收缩射血率指数、左心室每搏功指数及心率-压力乘积较高，平均肺毛细血管楔压较低（20±3 与 27±3[平均值±平均标准误]mmHg，P<0.001），左心室舒张末期压力较低（24±3 与 31±3mmHg，P<0.02）；两个运动时段的每搏指数及 S-T 段压低相似。4 例患者在两个运动时段左心室充盈压增加不显著。仰卧位运动时左心室充盈压异常的 16 例患者中，仅 10 例在坐位运动时有类似反应。在两种体位的静息及运动期间，左心室舒张末期压力与平均肺毛细血管楔压之间存在良好相关性。
