Left ventricular diastolic filling with an implantable ventricular assist device: beat to beat variability with overall improvement.
Left ventricular diastolic filling with an implantable ventricular assist device: beat to beat variability with overall improvement.
复制标题
使用植入式心室辅助装置进行左心室舒张充盈：逐搏变异性整体改善。
DOI：
10.1016/s0735-1097(97)00305-7
复制
发表时间：
1997
影响因子：
24
通讯作者：
McCarthy,PM
中科院分区：
文献类型：
--
作者：
Nakatani,S;Thomas,JD;Vandervoort,PM;Zhou,J;Greenberg,NL;Savage,RM;McCarthy,PM
目标。我们研究了植入式心室辅助装置对左室舒张充盈的影响。尽管许多研究者已经报道了植入式左室辅助装置对全身和外周循环的可靠支持，但对其对心脏功能的影响知之甚少。采用术中经食管多普勒超声心动图测定8例患者在置入左室辅助装置前后的舒张早期充盈峰值速度、舒张晚期充盈峰值速度、早期与早期充盈比、早期充盈减速时间、舒张期充盈周期及心房充盈分数。建立了一个数值模型来模拟这种情况。在装置插入前，所有患者显示限制性或单相透射血流模式。装置插入后，每个患者的透射血流显示快速的心跳变化，从异常松弛到限制模式。然而,当连续获得的平均值从10胜被认为,整体填充从基线明显规范化,早期充填速度从87±31 64±26厘米/秒(p < 0.01)和后期充填速度从32±8±11到23厘米/秒(p < 0.05),导致后期增加早期充填率从0.13±0.18,0.59±0.38 (p < 0.01)和心房填分数上升8±10%至26±17% (p < 0.01)。减速时间（从112±40 ms到160±44 ms， p < 0.05）和经RR区间校正的灌浆时间（从39±8%到54±10%，p < 0.005）也显著延长。在计算机模型中，异步左心室辅助在填充指标上产生显著的拍对拍变化，但总体上减速时间和其他变量归一化。在左室辅助下，每位患者的递质血流表现出快速变化的模式，但随着心房对充盈的贡献增加，整体舒张期充盈趋于正常化。由于辅助装置的递质血流模式是可变的，当从递质血流模式推断舒张功能时，必须考虑装置周期的时间。
Objectives. We studied the effects of left ventricular (LV) unloading by an implantable ventricular assist device on LV diastolic filling.Background. Although many investigators have reported reliable systemic and peripheral circulatory support with implantable LV assist devices, little is known about their effect on cardiac performance.Methods. Peak velocities of early diastolic filling, late diastolic filling, late to early filling ratio, deceleration time of early filling, diastolic filling period and atrial filling fraction were measured by intraoperative transesophageal Doppler echocardiography before and after insertion of an LV assist device in eight patients. A numerical model was developed to simulate this situation.Results. Before device insertion, all patients showed either a restrictive or a monophasic transmitral flow pattern. After device insertion, transmitral flow showed rapid beat to beat variation in each patient, from abnormal relaxation to restrictive patterns. However, when the average values obtained from 10 consecutive beats were considered, overall filling was significantly normalized from baseline, with early filling velocity falling from 87 ± 31 to 64 ± 26 cm/s (p < 0.01) and late filling velocity rising from 8 ± 11 to 32 ± 23 cm/s (p < 0.05), resulting in an increase in the late to early filling ratio from 0.13 ± 0.18 to 0.59 ± 0.38 (p < 0.01) and a rise in the atrial filling fraction from 8 ± 10% to 26 ± 17% (p < 0.01). The deceleration time (from 112 ± 40 to 160 ± 44 ms, p < 0.05) and the filling period corrected by the RR interval (from 39 ± 8% to 54 ± 10%, p < 0.005) were also significantly prolonged. In the computer model, asynchronous LV assistance produced significant beat to beat variation in filling indexes, but overall a normalization of deceleration time as well as other variables.Conclusions. With LV assistance, transmitral flow showed rapidly varying patterns beat by beat in each patient, but overall diastolic filling tended to normalize with an increase of atrial contribution to the filling. Because of the variable nature of the transmitral flow pattern with the assist device, the timing of the device cycle must be considered when inferring diastolic function from transmitral flow pattern.
登录
查看更多内容
使用心室辅助装置对患有急性心肌炎的婴儿进行左心支持
影响因子：
8.8
作者：
A. Chang;F. Hanley;S. Weindling;G. Wernovsky;D. Wessel
通讯作者：
D. Wessel
使用 Symbion 急性心室辅助装置系统为移植提供长期桥梁。
DOI：
10.1016/0003-4975(91)91362-y
发表时间：
1991
期刊：
The Annals of thoracic surgery
影响因子：
--
作者：
S. Lick;J. Copeland;L. Rosado;G. Sethi;R. Smith;M. Cleavinger
通讯作者：
M. Cleavinger
狗左心室不完全舒张的证据：根据等容压下降的时间常数进行预测。
DOI：
10.1172/jci109250
发表时间：
1978
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
M. Weisfeldt;J. Frederiksen;F. Yin;J. Weiss
通讯作者：
J. Weiss
DOI：
10.1253/jcj.46.124
发表时间：
1982-01-01
期刊：
JAPANESE CIRCULATION JOURNAL-ENGLISH EDITION
影响因子：
--
作者：
HORI, M;YELIIN, EL;SONNENBLICK, EH
通讯作者：
SONNENBLICK, EH
经食管和经胸超声心动图心脏尺寸的比较
影响因子：
0.3
作者：
Allan L. Klein;Robert M. Savage;F. Kahan;R. Murray;James D. Thomas;William J. Stewart;Marion R. Piedmonte;Patrick M. McCarthy;Delos M. Cosgrove
通讯作者：
Delos M. Cosgrove