Tanaka R, Tomita M, Noda T, Kagawa K, Nishigaki K, Yamaguchi M, Kunishima A, Fujiwara H
Second Department of Internal Medicine, Gifu University School of Medicine, Japan.
Heart Vessels. 1998;13(2):68-78. doi: 10.1007/BF01744589.
There are few studies regarding the assessment of left ventricular contractile function in patients with atrial fibrillation (AF). The aim of this study was to assess the left ventricular (LV) contractile function, i.e., the end-systolic pressure-volume relation (Ees) and a recently developed LV systolic myocardial stiffness constant (Ksm), without load manipulation in AF. In an experimental study of acute AF in dogs (n = 5), we were able to assess these indexes of the LV contractile function during acute AF, and found that the values were similar to those obtained during occlusion of the inferior vena cava (IVC) at the baseline state. During rapid ventricular pacing (140 or 160 bpm), the indices of LV contractile function increased due to the force-frequency relation (4.56 +/- 1.85, Ees baseline; 6.42 +/- 2.54*+, Ees pacing; 5.15 +/- 2.01 mmHg/ml, Ees AF; P < 0.05 vs baseline, +P < 0.05 vs. AF)(4.73 +/- 0.48, Ksm baseline; 6.24 +/- 1.12+, Ksm pacing; 3.99 +/- 1.14, Ksm AF; P < 0.05 vs baseline, +P < 0.05 vs AF). In a study of chronic clinical AF in patients without heart disease (lone AF, n = 7), the indexes of LV contractile function were preserved compared with those of control patients (CTL, n = 10) obtained during IVC occlusion; the values were decreased in patients with both AF and dilated cardiomyopathy (AFDCM, n = 5)(2.5 +/- 1.1, Ees CTL; 2.4 +/- 0.4, Ees lone AF; 1.1 +/- 0.3 mmHg/ml+, Ees AFDCM; P < 0.05 vs CTL, +P < 0.05 vs lone AF)(5.3 +/- 1.8, Ksm CTL; 4.9 +/- 1.6, Ksm lone AF; 2.7 +/- 0.2+, Ksm AFDCM; *P < 0.05 vs CTL, +P < 0.05 vs lone AF). Thus, during acute AF in dogs and in chronic AF patients, LV contractile function was assessed without load manipulation. In both the acute AF dogs and the chronic lone AF patients, LV contractile function was preserved, and in the AFDCM patients it was depressed.
关于心房颤动（AF）患者左心室收缩功能评估的研究较少。本研究的目的是在不进行负荷操作的情况下，评估心房颤动患者的左心室（LV）收缩功能，即收缩末期压力-容积关系（Ees）和最近开发的左心室收缩期心肌硬度常数（Ksm）。在一项对犬急性房颤的实验研究中（n = 5），我们能够在急性房颤期间评估这些左心室收缩功能指标，发现其值与基线状态下下腔静脉（IVC）闭塞时获得的值相似。在快速心室起搏（140或160次/分钟）期间，由于力-频率关系，左心室收缩功能指标增加（Ees基线：4.56±1.85；Ees起搏：6.42±2.54*+；Ees房颤：5.15±2.01 mmHg/ml；与基线相比P < 0.05，+与房颤相比P < 0.05）（Ksm基线：4.73±0.48；Ksm起搏：6.24±1.12+；Ksm房颤：3.99±1.14；与基线相比P < 0.05，+与房颤相比P < 0.05）。在一项对无心脏病患者（孤立性房颤，n = 7）慢性临床房颤的研究中，与IVC闭塞期间获得的对照患者（CTL，n = 10）相比，左心室收缩功能指标得以保留；在合并房颤和扩张型心肌病的患者（AFDCM，n = 5）中，这些值降低（Ees CTL：2.5±1.1；Ees孤立性房颤：2.4±0.4；Ees AFDCM：1.1±0.3 mmHg/ml+；与CTL相比P < 0.05，+与孤立性房颤相比P < 0.05）（Ksm CTL：5.3±1.8；Ksm孤立性房颤：4.9±1.6；Ksm AFDCM：2.7±0.2+；*与CTL相比P < 0.05，+与孤立性房颤相比P < 0.05）。因此，在犬急性房颤和慢性房颤患者中，在不进行负荷操作的情况下评估了左心室收缩功能。在急性房颤犬和慢性孤立性房颤患者中，左心室收缩功能均得以保留，而在AFDCM患者中则降低。
