Altered left ventricular diastolic properties during pacing-induced angina in patients with aortic stenosis.
Altered left ventricular diastolic properties during pacing-induced angina in patients with aortic stenosis.
复制标题
主动脉瓣狭窄患者起搏诱发心绞痛期间左心室舒张特性发生改变。
作者：
M. Fifer;P. Bourdillon;B. Lorell
在冠状动脉狭窄和局部需求缺血的心绞痛患者中，左室舒张压升高已被反复观察到，但舒张异常与左室节段性不同步的作用是有争议的。相比之下，主动脉狭窄引起的心绞痛患者更可能是弥漫性而非节段性缺血，因此可能为检查男性心绞痛的舒张生理学提供另一种模型。因此，我们检查了8例无明显冠状动脉疾病的主动脉狭窄患者心绞痛的血流动力学表现。起搏性心动过速诱发心绞痛，在对照期和停止起搏后立即心跳心绞痛期间测量血流动力学和超声心动图变量。心率（对照组vs心绞痛，69 +/- 12 vs 70 +/- 11次/分，p = NS）和左室收缩压峰值（207 +/- 39 vs 222 +/- 22 mm Hg, p = NS）在对照组和起搏后心绞痛期间相似。另一方面，起搏后心绞痛时左室舒张末期压明显升高（15 +/- 7 vs 28 +/- 8 mm Hg, p < 0.01）。等容松弛（TL）时左室压力下降的时间常数，以压力对时间的自然对数线性拟合斜率计算，从44 +/- 5增加到51 +/- 7 msec (p < 0.05)；从dP/dt对压力的线性拟合斜率得出的时间常数TD也略有增加，尽管变化没有统计学意义（69 +/- 5 vs 75 +/- 5 msec, p = .06）。（摘要删节250字）
An increase in left ventricular diastolic pressure has been repeatedly observed during angina in patients with coronary artery stenoses and regional demand ischemia, but the role of relaxation abnormalities versus left ventricular segmental dyssynchrony is controversial. In contrast, patients with angina due to aortic stenosis are likely to have diffuse rather than segmental ischemia and thus may provide an alternative model for examining the diastolic physiology of angina in man. Accordingly, we examined the hemodynamic manifestations of angina in eight patients with aortic stenosis without significant coronary artery disease. Angina was induced by pacing tachycardia, and hemodynamic and echocardiographic variables were measured in the control period and during angina in the beats immediately after cessation of pacing. Heart rate (control vs angina, 69 +/- 12 vs 70 +/- 11 beats/min, p = NS) and left ventricular peak systolic pressure (207 +/- 39 vs 222 +/- 22 mm Hg, p = NS) were similar in the control and postpacing angina periods. Left ventricular end-diastolic pressure, on the other hand, was significantly higher during postpacing angina (15 +/- 7 vs 28 +/- 8 mm Hg, p less than .01). The time constant of left ventricular pressure decline during isovolumetric relaxation (TL), calculated as the slope of a linear fit of the natural log of pressure vs time, increased from 44 +/- 5 to 51 +/- 7 msec (p less than .05); the time constant TD, derived from the slope of a linear fit of dP/dt vs pressure, also increased slightly, although the change was not statistically significant (69 +/- 5 vs 75 +/- 5 msec, p = .06).(ABSTRACT TRUNCATED AT 250 WORDS)
重新检查起搏压力测试：起搏引起的血流动力学变化与危险心肌数量的相关性。
影响因子：
24
作者：
McKay,RG;Aroesty,JM;Heller,GV;Silverman,KJ;Parker,JA;Als,AV;Come,PC;Kolodny,GM;Grossman,W
通讯作者：
Grossman,W
年轻瓣膜性或离散性瓣膜下主动脉狭窄患者的运动心电图、血压和工作能力。
DOI：
10.1016/0002-9149(82)91232-2
发表时间：
1982
期刊：
The American journal of cardiology
影响因子：
--
作者：
James,FW;Schwartz,DC;Kaplan,S;Spilkin,SP
通讯作者：
Spilkin,SP