The Scientific Basis for the Relations Between Pulsed‐Doppler Transmitral Velocity Patterns and Left Heart Chamber Properties
The Scientific Basis for the Relations Between Pulsed‐Doppler Transmitral Velocity Patterns and Left Heart Chamber Properties
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脉冲多普勒传输速度模式与左心室特性之间关系的科学依据
DOI：
--
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
G. Keren
中科院分区：
文献类型：
--
作者：
E. Yellin;J. Meisner;S. Nikolic;G. Keren
本文提出了一种教学方法，以了解复杂的关系，二尖瓣血流模式和心脏的性质。我们从一些观察开始，获得非侵入性，从正常和患病的人的心脏，并补充他们的非侵入性和侵入性观察从狗的实验室。然后，我们制定了一个概念性的方法，是一致的物理解释的数据，使我们能够澄清左心房和左心室的主动和被动属性的角色。这些基本概念被并入到计算模型中，其中心血管系统的特性可以变化以模拟舒张功能的生理和病理状态，从而产生正常和异常心室流动模式。我们目前的例子正常的心脏，压力超负荷肥大，扩张衰竭的心脏，心室顺应性差，但显然正常的流量模式。在这些条件下进行各种孤立的扰动的利益;最后，我们研究了心脏舒张指数的心室舒张的时间常数的系统变化的影响，和心输出量。有趣的发现包括：心室的特性和二尖瓣器的特性都可以产生模拟二尖瓣狭窄的血流模式;扩张的心室和舒张减慢的肥厚心室的A/E比大于正常值;在这两种情况下，A/E比也随着心输出量的减少而增加。因此，每搏输出量的变化，无论是由于舒张功能还是收缩功能，都会改变舒张功能的指标。最后，在向心性肥厚中：心房收缩力的大幅增加是A/E比值大的必要条件;心室舒张减慢本身不能使早期充盈减速减慢;还需要不完全舒张和心肌粘弹性。
This article presents a didactic approach toward understanding the complex relations between transmitral flow patterns and cardiac properties. We start with some observations, obtained noninvasively, from normal and diseased human hearts, and supplement them with noninvasive and invasive observations from the dog laboratory. We then formulate a conceptual approach that is consistent with a physical interpretation of the data, and that enables us to clarify the roles of the active and passive properties of the left atrium and left ventricle. These basic concepts are incorporated into a computational model wherein the properties of the cardiovascular system can be varied to simulate physiological and pathological states of diastolic function to produce normal and abnormal ventricular flow patterns. We present examples of normal hearts, pressure overload hypertrophy, dilated failing hearts, and ventricles with poor compliance but apparently normal flow patterns. Various isolated perturbations of interest were performed in each of these conditions; and finally, we studied the effects on diastolic indices of a systematic variation of the time constant of ventricular relaxation, and of cardiac output. Among the interesting findings are: flow patterns that mimic mitral stenosis can be created by the properties of the ventricle as well as by the properties of the mitral apparatus; the A/E ratio is greater than normal in the dilated ventricle and in the hypertrophied ventricle with slowed relaxation; and in both conditions, the A/E ratio also increases with decreased cardiac output. Thus, changes in stroke volume, whether due to diastolic or to systolic function, will change indices of diastolic function. Finally, in concentric hypertrophy: large increases in atrial contractility are a necessary condition for large A/E ratios; and slowed ventricular relaxation by itself is incapable of producing a slowed deceleration of early filling; incomplete relaxation and myocardial viscoelasticity are also required.
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左心房压力对区域峰值延长率的独立影响。
DOI：
10.1152/ajpheart.1990.259.2.h480
发表时间：
1990
期刊：
The American journal of physiology
影响因子：
--
作者：
Hoit,BD;LeWinter,M;Lew,WY
通讯作者：
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影响因子：
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影响因子：
37.8
作者：
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通讯作者：
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影响因子：
37.8
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影响因子：
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作者：
Nishimura,RA;Abel,MD;Hatle,LK;HolmesJr,DR;Housmans,PR;Ritman,EL;Tajik,AJ
通讯作者：
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