EFFECTS OF LEFT-VENTRICULAR LOAD AND CONTRACTILITY ON MITRAL REGURGITANT ORIFICE SIZE AND FLOW IN DOG
EFFECTS OF LEFT-VENTRICULAR LOAD AND CONTRACTILITY ON MITRAL REGURGITANT ORIFICE SIZE AND FLOW IN DOG
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DOI：
10.1161/01.cir.56.1.106
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发表时间：
1977-01-01
期刊：
影响因子：
37.8
通讯作者：
SONNENBLICK, EH
中科院分区：
文献类型：
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作者：
BORGENHAGEN, DM;SERUR, JR;SONNENBLICK, EH
在12只犬上，用闭胸二尖瓣部分切除术造成急性二尖瓣返流（MR），并测定MR压力梯度（MRG）、返流时间（VSI）和MR口面积（MRA）对二尖瓣返流量（MRV）的相对贡献。在MR诱导后和左心室舒张末期容积（EDV）增加、主动脉阻力（血管紧张素）增加以及心室收缩力（Ca或肾上腺素）增加后，测量主动脉和左心房压力、双平面左心室（LV）血管造影、前向血流和二尖瓣反流（MRF）。计算二尖瓣返流口面积，并通过血管造影测量二尖瓣环和瓣下区域的直径。血管紧张素和容量输注诱导MRF的大幅增加，这在很大程度上依赖于MRA的增加，但不是MRG，而收缩力的增强减少MRF伴随着MRA的减少，相对独立于MRG。左心室的大小和形状是MRA和由此产生的MRF在MR的主要决定因素。这些研究结果可能有助于解释的影响，如心室负荷和体积的临床过程中的MR的人。
Acute mitral regurgitation (MR) was produced in 12 dogs by closed chest partial valvulectomy and the relative contributions of MR pressure gradient (MRG), the time for regurgitant flow (VSI) and the MR orifice area (MRA) to mitral regurgitant volume (MRV) assessed. Aortic and left atrial pressures, biplane left ventricular (LV) angiography, forward flow and mitral regurgitant flow (MRF) were measured following MR induction and following augmentation of left ventricular end-diastolic volume (EDV), increased aortic resistance (angiotensin), and in the presence of increased ventricular contractility (Ca or epinephrine). Mitral regurgitation orifice area was determined by calculation and the diameters of the mitral anulus and subvalvular areas measured angiographically. Angiotensin and volume infusion induced a substantial increase in MRF which was largely dependent on an increase in MRA but not MRG, while augmentation of contractility decreased MRF accompanied by a decrease in MRA, relatively independent of MRG. Left ventricular size and shape are major determinants of MRA and resultant MRF in MR. These findings may help to explain the effects of such factors as ventricular loading and volume on the clinical course of MR in man.