CLINICAL APPLICATION OF END-SYSTOLIC P-V RELATIONS

这项研究计划的长期目标是定义临床 右室和左室收缩末期的有用性和局限性 压力-体积(P-V)关系。因此，假设 构成本研究方案的基本原理是：1)Emax和Vo 可以使用有创高保真微压计在患者中计算 右室和左室压力测量及右室和左室 双平面对比电影血管造影测得的脑室容量与平衡 放射性核素血管造影术；2)Emax与 右心收缩末期P-V关系的非电影血管成像估计 和左心室；3)正性肌力干预 Emax和Emax在方向性和数量上的相似变化 非电影血管造影双侧脑室收缩末期P-V关系； 收缩末期P-V关系的eMax和非电影血管造影估计为 适用于右或左室容量超负荷的患者 预测手术矫正的结果。以下是具体的 研究旨在回答这些假设：1)关系 非电影血管造影的收缩末压(应力)-体积 由峰或二向异性得到的(维)关系和体积截距 切迹肺动脉或主动脉压力与右室和左室绝对压力 平衡核素血管造影术测定的收缩末期容量 M型超声心动图测定的心室大小和室壁厚度 通过与相应权利的Emax和Vo进行比较来评估 用有创式高保真显微测压仪获取左心室 来自双平面对比造影的压力记录和容量 和放射性核素血管造影术；2)方向性和量性变化 在Emax、Vo和非电影血管造影的收缩末期P-V关系和 比较静息状态和变力状态下的容量截获 使用多巴酚丁胺或β-受体阻滞剂的状态；以及3)右和左的值 心脏Emax和Vo与非电影血管造影的收缩末压 (应力)-体积(尺寸)关系和体积(尺寸)截距 预测手术结果将在以下纵向研究中进行评估 接受右室或左室手术矫正的患者 容量超负荷损伤。因此，这项研究提案将提供新的 关于潜在的临床应用和局限性的数据 收缩末期P-V关系，尤其是右或左的患者 脑室容量超负荷。

The long term goal of this research proposal is to define the clinical usefulness and limitations of right and left ventricular end-systolic pressure-volume (P-V) relations. Accordingly, the hypotheses which constitute the rationale for this research proposal are: 1) Emax and Vo can be calculated in patients using invasive high-fidelity micromanometer right and left ventricular pressure measurements and right and left ventricular volumes from biplane contrast cineangiography and equilibrium radionuclide angiography; 2) a relationship exists between Emax and non-cineangiographic estimates of end-systolic P-V relations of the right and left ventricles; 3) inotropic interventions produce equivalent directional and quantitatively similar changes in Emax and non-cineangiographic end-systolic P-V relations of both ventricles; and 4) Emax and non-cineangiographic estimates of end-systolic P-V relations are useful in patients with right or left ventricular volume overload for predicting the results of operative correction. The following specific studies are designed to answer these hypotheses: 1) the relationship between non-cineangiographic end-systolic pressure (stress)-volume (dimension) relations and volume intercepts obtained from peak or dicrotic notch pulmonary or aortic pressures and absolute right and left ventricular end-systolic volumes by equilibrium radionuclide angiography and left ventricular dimensions and wall thickness by M-mode echocardiography will be assessed by comparison to Emax and Vo for the corresponding right and left ventricles obtained from invasive high-fidelity micromanometer pressure recordings and volumes from biplane contrast cineventriculography and radionuclide angiography; 2) the directional and quantitative changes in Emax and Vo and the non-cineangiographic end-systolic P-V relations and volume intercepts will be compared at rest and during altered inotropic state using dobutamine or beta-blockade; and 3) the value of right and left ventricular Emax and Vo and the non-cineangiographic end-systolic pressure (stress)-volume (dimension) relations and volume (dimension) intercepts for predicting surgical outcome will be assessed during longitudinal studies in patients undergoing operative correction of their right or left ventricular volume overload lesions. Thus, this research proposal will provide new data regarding the potential clinical usefulness and limitations of end-systolic P-V relations, especially in patients with right or left ventricular volume overload.