兔的动态左右心室相互作用：心室压力-容积环的同步测量

Dynamic right and left ventricular interactions in the rabbit: simultaneous measurement of ventricular pressure-volume loops.

作者信息

Pinsky M R, Perlini S, Solda P L, Pantaleo P, Calciati A, Bernardi L

机构信息

Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh, USA.

出版信息

J Crit Care. 1996 Jun;11(2):65-76. doi: 10.1016/s0883-9441(96)90022-2.

DOI:10.1016/s0883-9441(96)90022-2

PMID:8727028

Abstract

PURPOSE

This study was performed to characterize the dynamic factors determining ventricular interdependence in an open-pericardium intact animal model.

MATERIALS AND METHODS

Simultaneous measures of right ventricular (RV) and left ventricular (LV) pressures and volumes in 6 urethane-anesthetized open-chested, open-pericardium rabbits. RV and LV V were calculated every 2 milliseconds. Measurements were made at initial baseline blood volume, and again after two infusions of 20 mL/kg isoconductive colloid solution. At each blood volume level, partial aortic (AO), pulmonary artery (PAO), and inferior vena caval (IVC) occlusions were performed. Biventricular diastolic compliance and end-systolic elastance were calculated from these data.

RESULTS

Baseline end-diastolic (ED) and end-systolic (ES) V were 3.29 +/- 0.55 and 2.43 +/- 0.33 mL (mean +/- SD) for the LV, and 3.38 +/- 1.56 and 2.84 +/- 1.36 mL for the RV, respectively. AO increased all LV pressure and volume (P < .05) but did not alter RV ED volume (2.85 +/- 1.20 mL) or ED pressure (3.3 +/- 2.0 to 3.6 +/- 2.1 mm Hg). PAO increased RV ES pressure (P < .05) but did not alter RV ED volume, ED pressure, or ES volume, although it decreased LV ED volume (2.82 +/- 0.59, P < .05). AO also immediately increased end-systolic RV elastance to a value greater than that defined by IVC (7.9 +/- 4.4 to 10.9 +/- 6.6 mm Hg/mL, P < .05). Intravascular volume expansion though increasing baseline pressure and volume, did not alter qualitatively biventricular responses to AO, PA, or IVC.

CONCLUSION

Ventricular interdependence has both systolic and diastolic components that have differing directional effects. In the pericardectomized rabbit, increases in RV ED volume decrease LV ED volume by decreasing LV diastolic compliance, but do not alter LV systolic function. Whereas, increases in LV ED volume decrease RV ES volume resulting in an increase in RV maximal elastance, but minimally alter RV diastolic function.

摘要

目的

本研究旨在描述在开胸心包完整动物模型中决定心室相互依存的动态因素。

材料与方法

对6只氨基甲酸乙酯麻醉的开胸、心包开放的兔子同时测量右心室（RV）和左心室（LV）压力及容积。每2毫秒计算一次RV和LV容积。在初始基线血容量时进行测量，在两次输注20 mL/kg等渗胶体溶液后再次测量。在每个血容量水平，分别进行部分主动脉（AO）、肺动脉（PAO）和下腔静脉（IVC）阻断。根据这些数据计算双心室舒张顺应性和收缩末期弹性。

结果

LV的基线舒张末期（ED）和收缩末期（ES）容积分别为3.29±0.55和2.43±0.33 mL（平均值±标准差），RV分别为3.38±1.56和2.84±1.36 mL。AO增加了所有LV压力和容积（P<.05），但未改变RV的ED容积（2.85±1.20 mL）或ED压力（3.3±2.0至3.6±2.1 mmHg）。PAO增加了RV的ES压力（P<.05），但未改变RV的ED容积、ED压力或ES容积，尽管它降低了LV的ED容积（2.82±0.59，P<.05）。AO还立即将收缩末期RV弹性增加到大于IVC定义的值（7.9±4.4至10.9±6.6 mmHg/mL，P<.05）。血管内容量扩张虽然增加了基线压力和容积，但并未定性改变双心室对AO、PA或IVC的反应。