Prediction of the external work of the native heart from the dynamic H-Q curves of the rotary blood pumps during left heart bypass.
Prediction of the external work of the native heart from the dynamic H-Q curves of the rotary blood pumps during left heart bypass.
复制标题
根据左心搭桥期间旋转血泵的动态 H-Q 曲线预测原生心脏的外部功。
DOI：
10.1111/j.1525-1594.2010.01101.x
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发表时间：
2010
影响因子：
2.4
通讯作者：
S. Takatani
中科院分区：
文献类型：
--
作者：
Y. Yokoyama;O. Kawaguchi;T. Kitao;Taro Kimura;U. Steinseifer;S. Takatani
心室功能取决于旋转血泵的引流效果，而旋转血泵的功能又受心室脉动的影响。在这项研究中，使用心室压力-容积（P-V）图和rbp的动态头压-旁路流量（H，头压：动脉压减去心室压vs Q，旁路流量）曲线来检查心室和rbp之间的相互作用。我们首先在模拟循环中研究了被动填充心室的关系，然后在离体动物实验中进行了验证。专门制作了一个带有微压传感器的根尖引流管来获得心室压力，而放置在心脏壁上的三对超声晶体则用来计算心室容积。模拟环形心室顶降主动脉旁路术显示，P-V图内面积（EW(Heart)）表示的心室外功与动态H-Q曲线内面积（EW(VAD)）强烈相关，相关系数为R²= 0.869 ~ 0.961。模拟环的结果在3只体重为10 ~ 25 kg的柴羊的离体研究中得到验证，相关系数R²= 0.802 ~ 0.817。线性回归分析表明，旁路流量的增加降低了心室中表达的EW（心脏）和EW（VAD）的脉动性。模拟环和动物实验结果表明，rbp的心脏外功与H-Q性能之间的相互作用可以通过“EW(Heart) vs EW（VAD）”的关系来表达。原生心脏的搏动性质可以通过左心旁路时rbp EW(VAD) H-Q曲线下的面积来表达，这表明rbp的辅助水平和原生心脏功能的状态。
The ventricular performance is dependent on the drainage effect of rotary blood pumps (RBPs) and the performance of RBPs is affected by the ventricular pulsation. In this study, the interaction between the ventricle and RBPs was examined using the pressure-volume (P-V) diagram of the ventricle and dynamic head pressure-bypass flow (H-Q) curves (H, head pressure: arterial pressure minus ventricular pressure vs. Q, bypass flow) of the RBPs. We first investigated the relationships in a mock loop with a passive fill ventricle, followed by validation in ex vivo animal experiments. An apical drainage cannula with a micro-pressure sensor was especially fabricated to obtain ventricular pressure, while three pairs of ultrasonic crystals placed on the heart wall were used to derive ventricular volume. The mock loop-configured ventricular apical-descending aorta bypass revealed that the external work of the ventricle expressed by the area inside the P-V diagrams (EW(Heart) ) correlated strongly with the area inside dynamic H-Q curves (EW(VAD)), with the coefficients of correlation being R² = 0.869 ∼ 0.961. The results in the mock loop were verified in the ex vivo studies using three Shiba goats (10-25 kg in body weight), showing the correlation coefficients of R² = 0.802 ∼ 0.817. The linear regression analysis indicated that the increase in the bypass flow reduced pulsatility in the ventricle expressed in EW(Heart) as well as in EW(VAD) . Experimental results, both mock loop and animal studies, showed that the interaction between cardiac external work and H-Q performance of RBPs can be expressed by the relationships "EW(Heart) versus EW(VAD) ." The pulsatile nature of the native heart can be expressed in the area underneath the H-Q curves of RBPs EW(VAD) during left heart bypass indicating the status of the level of assistance by RBPs and the native heart function.