INFLUENCE OF ATRIAL SYSTOLE ON THE FRANK-STARLING RELATION AND THE END-DIASTOLIC PRESSURE-DIAMETER RELATION OF THE LEFT-VENTRICLE
INFLUENCE OF ATRIAL SYSTOLE ON THE FRANK-STARLING RELATION AND THE END-DIASTOLIC PRESSURE-DIAMETER RELATION OF THE LEFT-VENTRICLE
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DOI：
10.1161/01.cir.67.5.1045
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发表时间：
1983-01-01
期刊：
影响因子：
37.8
通讯作者：
TYBERG, JV
中科院分区：
文献类型：
--
作者：
LINDERER, T;CHATTERJEE, K;TYBERG, JV
在9只麻醉开胸犬上，观察了心房收缩对左室功能曲线（每搏输出量-舒张末期压或舒张末期内径）及左室舒张末期压-舒张末期内径关系的影响。在心包关闭和打开的容量负荷期间以及交替AV顺序起搏（允许心房对心室充盈的贡献）和AV同步起搏（防止心房贡献）期间进行测量。当心包关闭时，心房贡献的撤回使每搏输出量-舒张末期压力关系向下移动，但不使每搏输出量-舒张末期直径关系移动，即，根据舒张末期容积的减少，它减少了给定舒张末期压力的每搏输出量。每搏输出量-舒张末期压力关系的下移是由舒张末期压力-直径关系的上移引起的，对于给定的舒张末期压力，这导致舒张末期直径较小，因此导致每搏输出量较小。舒张末期压-直径关系上移的原因是心房保持充盈，从而通过增加心包容积来增加心包压。打开心包使舒张末期压力-直径关系向下和向右移动，使每搏输出量-舒张末期直径关系向上移动，并消除了心房收缩对这些曲线的影响。在存在完整心包的情况下，心房收缩明显改变了每搏输出量-舒张末期压的关系，因为它改变了舒张末期压-直径的关系，并且它通过增加前负荷改善了左心室性能。
The influence of atrial systole on the left ventricular function curve (stroke volume vs. end-diastolic pressure or end-diastolic diameter) and on the left ventricular end-diastolic pressure diameter relation was studied in 9 anesthetized, open-chest dogs whose atrioventricular (AV) node was completely blocked. Measurements were made during volume loading with the pericardium closed and opened and during alternate AV sequential pacing (to permit atrial contribution to ventricular filling) and AV simultaneous pacing (to prevent atrial contribution). When the pericardium was closed, withdrawal of the atrial contribution shifted the stroke-volume end-diastolic pressure relation downward, but did not shift the stroke-volume-end-diastolic diameter relation, i.e., it reduced stroke volume for a given end-diastolic pressure according to a reduction in end-diastolic volume. The downward shift of the stroke volume-end-diastolic pressure relation was caused by an upward shift of the end-diastolic pressure-diameter relation, which, for a given end-diastolic pressure, resulted in a smaller end-diastolic diameter and, thus, in a smaller stroke volume. The reason for the upward shift in the end-diastolic pressure-diameter relation was that the atrium remained full and thus increased pericardial pressure by increasing pericardial volume. Opening the pericardium shifted the end-diastolic pressure-diameter relation downward and to the right, shifted the stroke volume-end-diastolic diameter relation upward and abolished the effect of withdrawal of the atrial contribution on these curves. In the presence of an intact pericardium, atrial systole apparently shifts the stroke volume-end-diastolic pressure relation because it shifts the end-diastolic pressure-diameter relation, and it improves left ventricular performance by increasing preload.