The Effect of Right Ventricular Filling on the Pressure‐Volume Relationship of the Ejecting Canine Left Ventricle
The Effect of Right Ventricular Filling on the Pressure‐Volume Relationship of the Ejecting Canine Left Ventricle
复制标题
右心室充盈对射出犬左心室压力-容积关系的影响
作者：
W. Maughan;C. Kallman;A. Shoukas
在几种情况下，左心室的压力-容量关系会发生急剧的变化。这种现象的一个潜在机制是心室相互依赖，即右心室充盈对左心室的影响。在隔离的交叉循环射血犬心脏制剂中研究了TTiis机制，将气囊缝合在右和左心室并连接到容量腔，从而可以连续和准确地同时测量右和左心室的压力和容量。获得不同右室容量下左室压力-容量环的SETA图。在有和没有心包的情况下重复实验。同时对舒张期和收缩期进行了研究。我们的研究表明，在正常容量范围内工作的无心包心脏中，右室对左室压的影响很小。在有心包存在的情况下，右室容量对收缩和舒张期的左室压有微小但显著的影响。在停止跳动的心脏中施加更大范围的容量，即使没有心包，右心室也会影响左心室压力。因此，我们已经证明，无论是在舒张期还是在收缩期，心室的相互依赖都不太可能导致较大的急性压力-容量变化，除非存在显著高于正常右室容量的情况。
Acute shifts in the pressure-volume relationship of the left ventricle occur under several conditions. One potential mechanism for this phenomenon is ventricular interdependence, that is, the influence of right ventricular filling on the left ventricle. TTiis mechanism was studied in an isolated cross-circulated ejecting canine heart preparation with balloons sewn into both right and left ventricles and connected to volumetric chambers allowing continuous and accurate simultaneous measurement of right and left ventricular pressures and volume. Seta of left ventricular pressure-volume loops were obtained under a variety of right ventricular volumes. Experiments were repeated with and without the pericardium. Both diastole and systole were studied. We show that in the pericardium-free heart working over a normal range of volumes, the right ventricle exerts little influence on left ventricular pressure. With the pericardium present, there is a small but significant effect of right ventricular volume on left ventricular pressure during systole and diastole. Over a wider range of volumes imposed in the arrested heart, the right ventricle does influence left ventricular pressure even without the pericardium. Thus we have demonstrated that ventricular interdependence is not likely to lead to large acute pressure-volume shifts, either during diastole or systole, except in the presence of considerably above normal right ventricular volumes.