Direct assessment of right ventricular transmural pressure.
Direct assessment of right ventricular transmural pressure.
复制标题
直接评估右心室跨壁压。
DOI：
10.1161/01.cir.75.4.744
复制
发表时间：
1987
期刊：
影响因子：
37.8
通讯作者：
Little,WC
中科院分区：
文献类型：
--
作者：
Santamore,WP;Constantinescu,M;Little,WC
尽管跨壁压的测量很重要，但由于测量心包压的困难，跨壁压的计算变得复杂。最近，有人提出用扁平气球来测量心包压力。在较大的容量范围内，右心室舒张压和心包球囊压力在舒张期相似，表明右心室在生理容量下不受压力，并且右心房压力可用于估计心包压力。为了评估这些概念并间接评估使用扁平气球测量心包压力的准确性，对六只犬心脏进行了尸检。取出心包并将心脏浸入冷心脏停跳液中。将气球插入左右心室，获得左右心室压力-容积曲线。使右心室扩张至10、20、30和40ml分别需要2.6+/-0.5、3.9+/-0.9、5.9+/-1.4和8.9+/-2.4mmHg的右心室透壁压。对于左心室，在体积为10、20、30和40ml时记录的跨壁压分别为3.4+/-0.7、5.4+/-1.2、8.6+/-2.1和14.1+/-3.8mmHg。尽管在生理范围内右心室跨壁压小于左心室跨壁压，但右心室跨壁压始终为正值，并且随着心室容积的增加而增加。因此，右心室在整个生理容积范围内并非不受压力，这表明心包球囊压力可能高估心包压力，并且右心房压力不能用于估计心包压力。
Although the measurement of transmural pressure is important, calculation of transmural pressure is complicated by the difficulties in measuring pericardial pressure. Recently, flat balloons have been proposed to measure pericardial pressure. Over a wide range of volumes, right ventricular diastolic pressure and pericardial balloon pressure were similar in diastole, suggesting that the right ventricle is unstressed at physiologic volumes and that right atrial pressure can be used to estimate pericardial pressure. To evaluate these concepts and to assess indirectly the accuracy of measuring pericardial pressure using flat balloons, six canine hearts were examined postmortem. The pericardium was removed and the hearts were submerged in cold cardioplegic solution. Balloons were inserted into the right and left ventricles, and right and left ventricular pressure-volume curves were obtained. Right ventricular transmural pressures of 2.6 +/- 0.5, 3.9 +/- 0.9, 5.9 +/- 1.4, and 8.9 +/- 2.4 mm Hg were required to distend the right ventricle to 10, 20, 30, and 40 ml, respectively. For the left ventricle, transmural pressures of 3.4 +/- 0.7, 5.4 +/- 1.2, 8.6 +/- 2.1, and 14.1 +/- 3.8 mm Hg were recorded at volumes of 10, 20, 30, and 40 ml, respectively. Although the right ventricular transmural pressures were less than the left ventricular transmural pressures over the physiologic range, right ventricular transmural pressures were always positive and increased with increments in ventricular volume. Thus the right ventricle is not unstressed over the entire range of physiologic volumes, suggesting that pericardial balloon pressures may overestimate pericardial pressure and that right atrial pressure cannot be used to estimate pericardial pressure.