Studies on Starling's Law of the Heart: Determinants of the Relationship Between Left Ventricular End‐Diastolic Pressure and Circumference
Studies on Starling's Law of the Heart: Determinants of the Relationship Between Left Ventricular End‐Diastolic Pressure and Circumference
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斯塔林心脏定律的研究：左心室舒张末压与周长关系的决定因素
DOI：
10.1161/01.res.8.6.1254
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发表时间：
1960
影响因子：
20.1
通讯作者：
J. Ross
中科院分区：
文献类型：
--
作者：
E. Braunwald;R. Frye;J. Ross
在27只开胸犬上，用汞电阻法测量左室舒张末期周长，研究左室舒张末期压与周长的关系。在6个实验中，主动脉压、心输出量和心率独立变化。心动过速超过每个心脏的临界速率，对于任何给定的舒张末期周长，左心室舒张压升高。恒定心率下的低温也有类似的效果。由心动过速和体温过低引起的左心室舒张末期压力-舒张末期周长关系的改变被认为与不完全的心室舒张有关，这种舒张是随着心肌收缩持续时间的延长而发生的。急性自发性心力衰竭伴有任何给定舒张末期压的左心室舒张末期周长增加，这种效应可被认为反映了心肌伸展性的增加。左心室舒张末期压和舒张末期周长之间的关系并没有被主动脉压或心输出量的变化所改变。左心室舒张末期周长与张力-时间指数之间没有恒定的关系。事实上，可以操纵主动脉压和心输出量，使这两个参数向相反方向移动。这些观察结果与心肌耗氧量主要取决于舒张末期纤维长度的观点不一致。
The relationship between left ventricular end-diastolic pressure and circumference was studied in 27 open-chest dogs, utilizing a mercury-resistance gage to measure left ventricular end-diastolic circumference. In 6 experiments aortic pressure, cardiac output and heart rate were varied independently. Tachycardia above a rate critical for each heart elevated left ventricular eud-diastolic pressure for any given end-diastolic circumference. Hypothermia at a constant heart rate had a similar effect. The altered left ventricular end-diastolic pressure-end-diastolic circumference relationships resulting from tachycardia and hypothermia are believed to be related to the incomplete ventricular relaxation which occurs as the duration of diastole is encroached upon. Acute, spontaneous heart failure was accompanied by an augmented left ventricular end-diastolic circumference for any given end-diastolic pressure, an effect which may be considered to reflect an increase in myocardial extensibility. The relationship between left ventricular end-diastolic pressure and end-diastolic circumference was not modified either by changes of aortic pressure or of cardiac output. There was no constant relationship between the left ventricular end-diastolic circumference and the tension-time index. Indeed, it was possible to manipulate aortic pressure and cardiac output so that these 2 parameters moved in opposite directions. These observations are not consonant with the view that myocardial oxygen consumption is primarily dependent on end-diastolic fiber length.