Doppler flow velocity measurement to assess changes in inotropy and afterload: A study in healthy dogs
Doppler flow velocity measurement to assess changes in inotropy and afterload: A study in healthy dogs
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DOI：
10.1046/j.1540-8175.2002.00207.x
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发表时间：
2002-04-01
影响因子：
1.5
通讯作者：
Han, JJ
中科院分区：
文献类型：
--
作者：
Sohn, S;Kim, HS;Han, JJ
心肌收缩力和后负荷是充分循环的重要因素。为了无创评估正性肌力和后负荷的变化，在八只开胸犬服用正性肌力药和血管扩张药之前和之后，通过连续波多普勒超声心动图测量升主动脉血流量。在基线、三种不同剂量的肾上腺素（0.1、0.5和1杯/公斤/分钟）和硝普钠（1、4和8杯/公斤/分钟）给药时以及以不同组合同时输注两种药物后收集数据。肾上腺素输注导致峰值速度（PV）、平均加速度（MA）、速度时间积分（VTI）和分钟距离增加，而后负荷没有显着变化。随着正性肌力的增加，加速时间（AT）和射血时间（ET）略有减少的趋势，但没有显着性。硝普钠输注可导致血压和全身血管阻力指数 (ISVR) 呈剂量依赖性降低，这与 PV、MA 和分钟距离的增加以及 AT 的降低有关。硝普钠和肾上腺素联合输注，除非 ISVR 升高，否则会对 PV、MA、VTI 和分钟距离产生协同作用。然而，这些多普勒参数往往会随着后负荷的升高而减小。硝普钠输注期间获得的 ISVR 与 PV 和 MA 的相关性比与 VTI 或多普勒时间间隔的相关性更好。我们的研究表明，主动脉血流速度和加速度的多普勒测量可用于无创评估正性肌力和后负荷的变化。
Myocardial contractility and afterload are important factors for adequate circulation. To noninvasively assess changes in inotropy and afterload, ascending aortic blood flow was measured by continuous-wave Doppler echocardiography before and after the administration of an inotrope and a vasodilator in eight open chest dogs. Data were collected in the baseline, at three different doses of epinephrine (0.1, 0.5, and 1 mug/kg/min) and nitroprusside (1, 4, and 8 mug/kg/min) administration, and after a simultaneous infusion of both drugs in various combinations. Epinephrine infusion caused increases in peak velocity (PV), mean acceleration (MA), velocity time integral (VTI), and minute distance without a significant change in afterload. Acceleration time (AT) and ejection time (ET) showed a slight tendency to decrease with an increase in inotropy, but with no significance. Nitroprusside infusion produced dose-dependent decreases in blood pressure and index of systemic vascular resistance (ISVR), which was associated with increases in PV, MA, and minute distance, and with a decrease in AT The combined infusion of nitroprusside and epinephrine, unless ISVR was elevated, produced synergistic effects on PV, MA, VTI, and minute distance. However, these Doppler parameters tended to diminish with an elevation in afterload. ISVR obtained during nitroprusside infusion had a better correlation with both PV and MA than with VTI or the Doppler time intervals. Our study suggests that Doppler measurement of aortic blood flow velocity and acceleration can be used for the noninvasive assessment of changes in inotropy and afterload.