STUDIES ON STARLINGS LAW OF HEART .9. EFFECTS OF IMPEDING VENOUS RETURN ON PERFORMANCE OF NORMAL + FAILING HUMAN LEFT VENTRICLE
STUDIES ON STARLINGS LAW OF HEART .9. EFFECTS OF IMPEDING VENOUS RETURN ON PERFORMANCE OF NORMAL + FAILING HUMAN LEFT VENTRICLE
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DOI：
10.1161/01.cir.30.5.719
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发表时间：
1964-01-01
期刊：
影响因子：
37.8
通讯作者：
BRAUNWALD, E
中科院分区：
文献类型：
--
作者：
ROSS, J;BRAUNWALD, E
对14例左心导管置入术患者的急性循环反应进行了研究，目的是观察下腔静脉球囊膨胀对静脉回流心脏的影响。在无临床或血流动力学证据的5例左室功能受损患者中，左室舒张末压下降，并伴有心脏指数、左室卒中容积和左室卒中功的降低。在9例左心室功能受损的患者中，虽然左心室功能曲线与左心室舒张末期压与左心室卒中功的关系一般比无左心室疾病的患者更平坦、更低，但在方向性上也有类似的反应。在球囊充气期间，没有患者出现心脏指数、卒中容量或左心室卒中功的显著增加。由此得出的结论是，在正常和抑郁的人类左心室中，Starling关系似乎以一种方向相似的方式运作，并且功能受损患者的左心室不在曲线的下降分支上。然而，当对患病心室施加额外的工作负荷时，左心室斯塔林曲线的降肢可能变得明显。
The acute circulatory responses to impeding venous return to the heart by the inflation of a balloon in the inferior vena cava were determined in 14 patients undergoing left heart catheterization. In the 5 patients without clinical or hemodynamic evidence of impaired left ventricular function, left ventricular end-diastolic pressure fell, and the decrease was accompanied by reductions in the cardiac index, left ventricular stroke volume, and left ventricular stroke work. In 9 patients with impaired left ventricular function, directionally similar responses were noted, although the left ventricular function curves relating left ventricular end-diastolic pressure to left ventricular stroke work were generally flatter and lower than those in the patients without left ventricular disease. In none of the patients did a significant increase in cardiac index, stroke volume, or left ventricular stroke work occur during inflation of the balloon. It is concluded that the Starling relationship appears to operate in a directionally similar manner both in the normal and the depressed human left ventricle, and that the left ventricles of patients with impaired function are not on a descending limb of the curve. However, a descending limb of the left ventricular Starling curve may be become apparent when an additional work load is imposed on the diseased ventricle.