EFFECTS OF VENTRICULAR PACING ON REGIONAL LEFT-VENTRICULAR PERFORMANCE IN THE DOG
EFFECTS OF VENTRICULAR PACING ON REGIONAL LEFT-VENTRICULAR PERFORMANCE IN THE DOG
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DOI：
10.1152/ajpheart.1980.238.6.h858
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发表时间：
1980-01-01
影响因子：
--
通讯作者：
COVELL, JW
中科院分区：
文献类型：
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作者：
BADKE, FR;BOINAY, P;COVELL, JW
在麻醉开胸犬上观察了两组心室起搏引起的左心室局部收缩功能的变化。在第1组5只犬中，通过心房、右心室、LV心尖和LV基底起搏的超声晶体对评估LV前基底、前尖和后尖的局部功能。与心房起搏相比，心室起搏产生了收缩的间歇性和每个部位缩短模式的显著变化，以及峰值收缩压和峰值dP/dt [左心室压力一阶导数]平均降低27%。在心室起搏期间测量的所有部位，LV射血期间缩短的程度均降低或不变。第2组5只犬，通过心房和左室侧壁起搏研究间隔和对侧左室侧壁的功能。用晶体对评估外侧功能，通过植入隔膜中的铅珠的放射性电影摄影评估隔膜功能。心室起搏时，两壁之间产生相互作用，早期外侧壁缩短引起间隔膨出，晚期间隔缩短引起外侧壁收缩期延长。心室起搏可引起局部心肌功能的显著变化，这可能是由相对心肌区域的相互作用引起的。这种相互作用似乎对整体心室功能有害，可能是因为体积被隔离，压力被耗散到与收缩心肌的体积异相的相对不活跃的节段中。
Changes in regional left ventricular (LV) performance induced by ventricular pacing were studied in 2 groups of open-chest anesthetized dogs. In the 1st group of 5 dogs, local function at the LV anterior base, anterior apex and posterior apex was assessed by ultrasonic crystal pairs with atrial, right ventricular, LV apical and LV base pacing. Ventricular pacing produced asynchrony of contraction and marked changes in the shortening pattern at each site, as well as an average 27% reduction in peak systolic pressure and peak dP/dt [1st derivative LV pressure] compared to atrial pacing. The extent of shortening during LV ejection was reduced or unchanged at all sites measured during ventricular pacing. In the 2nd group of 5 dogs, function of the septum and opposing LV lateral wall was studied with atrial and LV lateral wall pacing. Lateral function was assessed with a crystal pair and septal function by cineradiography of a Pb bead implanted in the septum. Ventricular pacing produced reciprocal interaction between the 2 walls, with early lateral shortening inducing septal bulging and late septal shortening inducing lateral wall systolic lengthening. Ventricular pacing produces significant changes in regional myocardial function, likely induced by reciprocal interaction of opposing myocardial regions. Such interaction appears deleterious to global ventricular function, presumably because volume is sequestered and pressure is dissipated into relatively inactive segments that are out of phase with the bulk of contracting myocardium.