Comprehensive analysis of effective reflection distance and its association with wave reflection strength under diverse hemodynamic conditions in anesthetized dogs.
Comprehensive analysis of effective reflection distance and its association with wave reflection strength under diverse hemodynamic conditions in anesthetized dogs.
复制标题
综合分析麻醉犬不同血流动力学条件下的有效反射距离及其与波反射强度的关系。
DOI：
10.1016/j.jbiomech.2020.109753
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发表时间：
2020
期刊：
影响因子：
2.4
通讯作者：
Sugimachi M.
中科院分区：
文献类型：
--
作者：
Uemura K;Nishikawa T;Kawada T;Sugimachi M.
压力波反射与心血管风险相关。有效反射距离（Effective Reflection Distance，ERD）是到理论上的主要反射点的概念距离，它与临床上的老化和增强指数（Alx）有关。然而，目前尚不清楚是否以及如何ERD变化和关联时，血流动力学条件是急性扰动的病人AIx。本研究的目的是在严格控制的动物实验中解决这个问题。在13只麻醉犬中，我们测量了动脉压、主动脉流量和股动脉流量，同时通过给予扎替雷定（心动过缓剂）、硝普钠（血管扩张剂）、去甲肾上腺素（血管收缩剂）、多巴酚丁胺（正性肌力药）和右旋糖酐（容量扩张剂）在很大范围内改变血液动力学状况。使用测量的数据，我们基于包含具有复杂频率依赖性负载（ERDTL）的管道的动脉模型确定了ERD，该模型已被认为是生理上有效的模型。我们还根据波分离（ERDWSA）和基于压力的分析（ERDWSA）确定了ERD。在使用汇总数据的多元回归分析中，硝普钠或多巴酚丁胺输注显著缩短了ERDTL，并且与AIx显著负相关。ERDWSA或ERDAW不一定与ERDTLin对药物给药的反应或与AIx的相关性相关。总之，在不同的血流动力学条件下，ERDTL的变化敏感，并显示生理合理的关联与AIx。这一结果证实了在波反射的临床分析中密切关注药物的重要性。当使用ERDWSA或ERDA作为ERDTL的替代品时，需要谨慎。
Pressure wave reflection is associated with cardiovascular risk. The conceptual distance to a theoretical major reflection site, termed effective reflection distance (ERD), has been associated with aging and augmentation index (AIx) clinically. However, it remains unclear whether and how ERD varies and associates with AIx when the hemodynamic condition is acutely perturbed in a patient. The objective of this study was to address this issue in rigorously controlled animal experiments. In 13 anesthetized dogs, we measured arterial pressure, aortic flow and femoral arterial flow, while altering the hemodynamic condition over wide ranges by administering zatebradine (bradycardic agent), nitroprusside (vasodilator), noradrenaline (vasoconstrictor), dobutamine (inotrope), and dextran (volume-expander). Using the measured data, we determined ERD based on an arterial model comprising a tube with a complex frequency-dependent load (ERDTL), which has been considered a physiologically valid model. We also determined ERD based on wave separation (ERDWSA) and pressure-based analyses (ERDAW). ERDTLwas shortened significantly in response to nitroprusside or dobutamine infusion, and was significantly and negatively associated with AIx in multiple regression analysis using pooled data. ERDWSAor ERDAWdid not necessarily correlate with ERDTLin terms of responses to drug administration or association with AIx. In conclusion, under diverse hemodynamic conditions, ERDTLchanges sensitively and shows physiologically reasonable association with AIx. This result substantiates the importance of paying close attention to medications during clinical analysis of wave reflection. Caution is required when using ERDWSAor ERDAWas an alternative to ERDTL.