The Linearity of the End‐systolic Pressure‐Volume Relationship in Man and Its Sensitivity for Assessment of Left Ventricular Function
The Linearity of the End‐systolic Pressure‐Volume Relationship in Man and Its Sensitivity for Assessment of Left Ventricular Function
复制标题
人体收缩末期压力-容积关系的线性及其对左心室功能评估的敏感性
DOI：
10.1161/01.cir.63.6.1216
复制
发表时间：
1981
期刊：
影响因子：
37.8
通讯作者：
W. Kübler
中科院分区：
文献类型：
--
作者：
H. Mehmel;B. Stockins;K. Ruffmann;K. Olshausen;G. Schuler;W. Kübler
本文对11例冠心病和1例充血性心肌病患者的收缩末期压力-容积（P-Ves）与左室变力状态的关系进行了线性和敏感性研究。为了尽量减少自主神经反射反应，在研究开始时静脉注射普萘洛尔0.15 mg/kg和阿托品1 mg。分别在安静时、口服硝酸异山梨酯10 mg（收缩压下降15 mmHg）和静注甲氧胺2 mg/min（收缩压升高10 mmHg）三个时间点进行心室造影，三个时间点的P-Ves关系均呈线性（r = 0.96）。PVes关系的斜率k与静息时左室射血分数之间的关系最好用指数函数描述（r = 0.94）。使用收缩压峰值代替收缩末期压显示同样良好的结果。横坐标上PVes线的截距代表零压时的理论收缩末期容积，与对照条件下的射血分数无关。期外收缩后搏动的P-Ves关系向左移位（收缩末期容积较小），并变得更陡。
The linearity and sensitivity of the end-systolic pressure-volume (P-Ves) relation to the inotropic state of the left ventricle were investigated in 11 patients with coronary heart disease and one patient with congestive cardiomyopathy. To minimize autonomic reflex responses, propranolol, 0.15 mg/kg, and atropine, 1 mg, were administered i.v. at the beginning of the study. Three ventriculograms were performed: at rest, after oral isosorbide dinitrate, 10 mg (systolic pressure decrease 15 ⩾ mm Hg), and during infusion of methoxamine, 2 mg/min (systolic pressure increase ⩾ 10 mm Hg).The three points of the P-Ves relation showed linearity (r ⩾ 0.96). The relation between the slope k of the PVes relation and the left ventricular ejection fraction at rest was best described by an exponential function (r = 0.94). The use of peak systolic pressure instead of end-systolic pressure showed equally good results. The intercept of the PVes line on the abscissa, which represents the theoretical end-systolic volume at zero pressure, was not related to the ejection fraction under control conditions. The P-Ves relation in postextrasystolic beats was displaced toward the left (smaller end-systolic volumes) and became steeper.