Charan N B, Ripley R, Carvalho P
Pulmonary Research Laboratory, Section of Pulmonary/Critical Care Medicine (111), VA Medical Center, Boise, Idaho 83702, USA.
Respir Physiol. 1998 May;112(2):227-35. doi: 10.1016/s0034-5687(98)00012-7.
We studied the effect of increased coronary venous pressure (Pcv) on left ventricular (LV) function in nine anesthetized open-chested sheep. Pcv was increased by inflating a balloon in the coronary sinus. LV function was estimated by measuring maximum rate of change in LV pressure (dP/dt max) and LV end-diastolic pressure (LVEDP). Left anterior descending (LAD) coronary artery blood flow was measured with an electromagnetic flow probe. A control group (n=6) was studied similarly except that Pcv was not elevated. After completion of the experiment, LV wet/dry weight ratios were measured to estimate LV myocardial water content. The balloon inflation increased Pcv from 8.6+/-1.1 to 23.8+/-1.7 mmHg (mean+/-SEM), which decreased dP/dt max from 1611+/-236 at baseline to 1041+/-210 after 120 min of increased Pcv (P < 0.05). The dP/dt max in the control group did not change significantly. Heart rate, LAD flow, LVEDP, and aortic pressures were similar in two groups but the LV water content was significantly higher (P < 0.05) in the experimental group (76.2+/-1.0 vs. 79.1+/-0.5%). These data suggest that acute increases in Pcv result in LV dysfunction and that coronary vascular congestion and myocardial edema may, at least in part, be responsible for this finding.
我们研究了在9只麻醉开胸绵羊中增加冠状静脉压力（Pcv）对左心室（LV）功能的影响。通过在冠状窦内充盈球囊来增加Pcv。通过测量左心室压力的最大变化率（dP/dt max）和左心室舒张末期压力（LVEDP）来评估左心室功能。使用电磁流量探头测量左前降支（LAD）冠状动脉血流量。设立一个对照组（n = 6），进行类似研究，只是不升高Pcv。实验完成后，测量左心室湿/干重比以估计左心室心肌含水量。球囊充盈使Pcv从8.6±1.1 mmHg增加到23.8±1.7 mmHg（平均值±标准误），这使得dP/dt max从基线时的1611±236降至Pcv升高120分钟后的1041±210（P < 0.05）。对照组的dP/dt max没有显著变化。两组的心率、LAD血流量、LVEDP和主动脉压力相似，但实验组的左心室含水量显著更高（P < 0.05）（76.2±1.0%对79.1±0.5%）。这些数据表明，Pcv的急性增加会导致左心室功能障碍，冠状血管充血和心肌水肿可能至少部分地导致了这一结果。
