Mechanism of sustained mechanical alternans. Effect of variations in ventricular billing volume.
Mechanism of sustained mechanical alternans. Effect of variations in ventricular billing volume.
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持续机械交替的机制。
DOI：
10.1161/01.res.69.1.26
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发表时间：
1991
影响因子：
20.1
通讯作者：
Yellin,EL
中科院分区：
文献类型：
--
作者：
Adler,D;Nikolic,S;Sonnenblick,EH;Yellin,EL
本研究通过使用定量标准调查了持续力学交替（SMA）现象。离散分析表明，SMA期间的血流动力学变量是由一个简单的数学关系控制的。分析表明，两个交替节拍在脑卒中容积(SV)-舒张末期容积（EDV）平面上产生的斜率值为gamma = (mu - 1) (1 + beta)/(mu - beta)，其中mu = SVs/SVw，其中SVs和SVw分别表示一种收缩状态下的强拍和弱拍，SVs和SVw分别表示两种交替收缩状态下高拍和低拍；beta = FVs/FVw，其中FVs和FVw分别为上车和上车之后的填充量。无论SMA是在一种或两种收缩状态下表现出来，也无论SV-EDV函数关系如何，这个方程都是有效的。假设后负荷恒定，基于该斜率（伽马）的标准被描述为确定SMA是否由EDV和FV的变化引起。在一个收缩状态（用gamma表示）存在时，SV-EDV曲线的斜率是直接确定的（8只狗34次），通过使用遥控二尖瓣在稳定状态后防止心跳中的FV。斜率gamma = 0.892 +/- 0.078与文献数据一致。在另外10只狗中，测量了55组SMA的二尖瓣血流和主动脉血流。在51个序列中，大于1。由于存在一种收缩状态时的实验斜率小于或等于1，因此拒绝该系列中存在一种收缩状态的可能性。另一方面，当涉及到两个收缩状态时，两个连续拍在SV-EDV平面上产生的斜率，伽马，是通过连接两个SV-EDV关系来确定的。这个斜率趋于大于1。因此，在这51个系列中，SMA不能解释为Frank-Starling机制和FV变化的结果，而是两种交替收缩状态的结果。在其他四个系列中，伽马的值可以与一个收缩状态或两个交替收缩状态的存在兼容。这种定量分析能够将各种类型的SMA分类为具有明确特征的子类别。定量分析表明，SMA的共同成因是交替收缩状态。
This study investigations the phenomenon of sustained mechanical alternans (SMA) through the use of quantitative criteria. Discrete analysis is used to demonstrate that the hemodynamic variables during SMA are governed by a simple mathematical relation. The analysis shows that the value of the slope created by the two alternating beats on the stroke volume (SV)-end-diastolic volume (EDV) plane is gamma = (mu - 1) (1 + beta)/(mu - beta), where mu = SVs/SVw, and SVs and SVw denote the strong and weak beats, respectively, in the presence of one contractile state, and the beats associated with the higher and lower contractile states, respectively, in the presence of two alternating contractile states; beta = FVs/FVw, where FVs and FVw are the filling volumes after SVs and SVw, respectively. This equation is valid, whether SMA is exhibited in the presence of one or two contractile states and irrespective of the SV-EDV functional relation. Assuming constant afterload, a criterion based on this slope (gamma) is described to determine if SMA is caused by variations in EDV and FV. The slope of the SV-EDV curve in the presence of one contractile state (denoted as gamma) was determined directly (34 runs in eight dogs) by preventing FV in a beat, after a steady state, using a remote-controlled mitral valve. The slope gamma = 0.892 +/- 0.078 was found to agree with data in the literature. In 10 other dogs, mitral flow and aortic flow were measured in 55 series of SMA. In 51 series, gamma was greater than 1. Because the experimental slope in the presence of one contractile state, gamma, is smaller than or equal to 1, the possibility that one contractile state is involved in this series is rejected. On the other hand, when two contractile states are involved, the slope that the two successive beats create on the SV-EDV plane, gamma, is determined by connecting the two SV-EDV relations. This slope tends to be greater than 1. Thus, in these 51 series, SMA cannot be explained as a result of the Frank-Starling mechanism and variations in FV but as a result of two alternating contractile states. In the other four series, the value of gamma can be compatible either with the presence of one contractile state or with two alternating contractile states. This quantitative analysis enables the classification of the various types of SMA into subcategories with well-defined features. The quantitative analysis presented here shows that the common genesis of SMA is an alternating contractile state.
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狗心脏不和谐的交替脉。
DOI：
10.1152/ajplegacy.1967.212.6.1515
发表时间：
1967
期刊：
The American journal of physiology
影响因子：
--
作者：
J. P. Gilmore;W. J. Powell;T. Graham;R. Clancy
通讯作者：
R. Clancy
DOI：
10.1152/ajplegacy.1965.209.5.945
发表时间：
1965
期刊：
The American journal of physiology
影响因子：
--
作者：
J. Gilbert;M. Janse;H. Lu;J. Pinkston;C. Brooks
通讯作者：
C. Brooks
循环动力学
影响因子：
--
作者：
P. Wood
通讯作者：
P. Wood
斯塔林心脏定律的研究：左心室舒张末压与周长关系的决定因素
影响因子：
20.1
作者：
E. Braunwald;R. Frye;J. Ross
通讯作者：
J. Ross
交替脉的动力学：交替舒张末期纤维长度作为致病因素。
DOI：
10.1172/jci104696
发表时间：
1963
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
J. H. Mitchell;S. Sarnoff;E. Sonnenblick
通讯作者：
E. Sonnenblick