The slope of the end–systolic pressure–volume relationship compared with the global end–systolic pressure–volume ratio in humans
The slope of the end–systolic pressure–volume relationship compared with the global end–systolic pressure–volume ratio in humans
复制标题
人体收缩末压-容积关系与整体收缩末压-容积比的斜率
DOI：
10.1002/clc.4960130106
复制
发表时间：
1990
影响因子：
2.7
通讯作者：
R. Beyar
中科院分区：
文献类型：
--
作者：
L. Abboud;A. Battler;S. Rath;S. Sideman;R. Beyar
临床上通过负荷调节产生的收缩末期压力-容量关系(Emax)的斜率，以及“绝对”收缩末期压力-收缩末期容量比(记为压力-体积比)，被认为是定义左心功能的指标。本研究试图通过对20名接受心导管术的患者(16名冠状动脉疾病患者和4名冠状动脉正常患者)的研究来确定这两项指标之间的关系。每例患者行3次左心室造影：(1)对照组基础状态，(2)快速静脉滴注250-300毫升生理盐水，(3)舌下注射硝酸异山梨酯5 mg。对于这三种不同的负荷，用左心室最大压力(替代收缩末期压力)和最小左心室(收缩末期)容量来近似线性回归。4例患者在生理盐水负荷过程中出现急性心肌缺血并伴有典型的胸痛和心电图改变。急性脑缺血患者的压力/体积比无明显变化，由4.4±1.3降至2.9±0.9 mm Hg/ml(p<；0.001)。在所有患者中，压力-容量比与射血分数相关(r=0.6；p<；0.05)，而与Emax无关。此外，Emax线表现出明显的非生理性Vo。Emax与压力-体积比无相关性。一般来说，Emax和峰值收缩压/容量比之间存在显著差异，后者具有简单、对急性缺血敏感以及与公认的EF指数相关的优势。
The slope of the end–systolic pressure–volume relationship (Emax), which is generated clinically by load manipulation, as well as the “absolute” peak systolic pressure end–systolic volume ratio (denoted as pressure–volume ratio), have been suggested as indices defining left ventricular function. This study represents an attempt to determine the relationship between these two indices by studying 20 patients (16 with coronary artery disease and 4 with normal coronary arteries) undergoing cardiac catheterization. Left ventriculography was performed three times in each patient: (1) in the control baseline state, (2) after rapid intravenous infusion of 250–300 cc of saline, and (3) after sublingual administration of 5 mg isosorbide dinitrate. Emax was approximated by linear regression using the peak left ventricular pressure (replacing endsystolic pressure) and the smallest left ventricular (endsystolic) volume for these three different loads. Actue ischemia with typical chest pain and ECG changes developed in 4 patients during saline loading. The pressure–volume ratio showed no change with load manipulation in patients who developed acute ischemia, the pressure–volume ratio dropped from 4.4±1.3 to 2.9±0.9 mmHg/ml (p < 0.001). In all of the patients, the pressure–volume ratio, but not the Emax, correlated with the ejection fraction (r = 0.6; p<0.05). In addition, the Emax line demonstrated a markedly nonphysiological Vo. There was no correlation between Emax and pressure–volume ratio. Generally, there was a significant disparity between Emax and the peak systolic pressure–volume ratio, with the latter having the advantage of simplicity, sensitivity to acute ischemia, and a correlation with the well–established EF index.
影响因子：
37.8
作者：
KASS, DA;YAMAZAKI, T;SAGAWA, K
通讯作者：
SAGAWA, K