DETERMINATION OF LEFT-VENTRICULAR END-SYSTOLIC PRESSURE-VOLUME RELATIONSHIPS BY THE CONDUCTANCE (VOLUME) CATHETER TECHNIQUE
DETERMINATION OF LEFT-VENTRICULAR END-SYSTOLIC PRESSURE-VOLUME RELATIONSHIPS BY THE CONDUCTANCE (VOLUME) CATHETER TECHNIQUE
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DOI：
10.1161/01.cir.73.3.586
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发表时间：
1986-03-01
期刊：
影响因子：
37.8
通讯作者：
SAGAWA, K
中科院分区：
文献类型：
--
作者：
KASS, DA;YAMAZAKI, T;SAGAWA, K
用多电极电导导管测量连续左心室容量，在开胸麻醉犬中原位测定收缩末期压力-容量关系(ESPVR)。狗(n=8)在对照组和药物交感神经切除(六甲溴铵)和外科迷走神经切断术后，分别在注射多巴酚丁胺前后进行研究。采用球囊下腔静脉结扎术(IVCBO)，在短时间内(5~6s)测定ESPVR。这种关系具有很高的重复性。斜率(Ees)和体积截距(Vo)(平均值+-。SD)在对照系列中为5.8.+-。3.6毫米汞柱/毫升和6.5毫米汞/毫升。分别为12.5ml。在IVCBO(预负荷恢复)释放时，EES为7.7+-。3.6毫米汞柱/毫升，Vo为12.4。9.6毫升(p<；0.01)。自主神经阻断使EES减少50%，Vo随之减少(p<；.01)，消除了前负荷减少(IVCBO)和前负荷恢复(IVCBO释放)产生的ESPVR之间的差异。随后注射多巴酚丁胺使EES增加到6.1。+-。3.5毫米汞柱/毫升和Vo至4.1。+-。6.9ml，与报道的正性肌力干预下ESPVR的变化一致。在左心室容量导管信号中观察到右心室充盈的小伪影，但这并没有明显改变ESPVR。这些结果证明了通过电导导管和短暂的IVCBO原位测定ESPVR的可行性，并强调了在测量过程中使用快速负荷变化以最大限度地减少反射激活的重要性。
Using a multielectrode conductance catheter to estimate continuous left ventricular volume we determined the end-systolic pressure-volume relationship (ESPVR) in situ in open-chest anesthetized dogs. Dogs (n=8) were studied in the control state and after pharmacologic sympathectomy (hexamethonium) and surgical vagotomy both before and after the administration of dobutamine. ESPVR was measured during brief (5 to 6 sec) preload reduction by balloon occlusion of the inferior vena cava (IVCBO). The relationship was highly reproducible. The slope (Ees) and volume intercept (Vo) (mean .+-. SD) in the control series were 5.8 .+-. 3.6 mm Hg/ml and 6.5 .+-. 12.5 ml, respectively. Upon release of the IVCBO (preload recovery), Ees was 7.7 .+-. 3.6 mm Hg/ml and Vo was 12.4 .+-. 9.6 ml (p < .01). Autonomic blockade produced a 50% reduction in Ees and a concomitant decrease in Vo (p < .01), and eliminated the difference between ESPVR generated by preload reduction (IVCBO) and preload recovery (IVCBO release). Subsequent dobutamine infusion increased Ees to 6.1 .+-. 3.5 mm Hg/ml and Vo to 4.1 .+-. 6.9 ml, consistent with reported changes of the ESPVR with positive inotropic intervention. A small artifact of right ventricular filling was observed in the left ventricular volume catheter signal, but this did not appreciably alter the ESPVR. These results demonstrate the feasibility of the determination of ESPVR in situ by the conductance catheter and brief IVCBO and underline the importance of the use of rapid load changes to minimize reflex activation during the measurements.