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Journal of Cardiology and Clinical Management最新文献

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The Left Ventricular End-Systolic Pressure Correlation with Aortic Valve Timing; a Novel Inotropic Index Description Using a Dual Pressure Catheter 左室收缩压与主动脉瓣时间的相关性研究用双压导管描述一种新的肌力指数
Pub Date : 2022-03-05 DOI: 10.56391/jccm.2022.1012
F. Konecný
Myocardial contraction is generated by ventricular pressure in early systole by the isometric force against closed valves, as ventricle is contracting without changing volume. This initial contractile phase of cardiac cycle (early systole) is followed by rapid shortening, isotonic contraction, allowing ejection of the blood against changing LV afterload. LV is coupled to the systemic arterial pressure; hence LV ejection is closely linked to the properties of the aortic valve, aorta, and its distributing arteries. Isometric relationship in the LV was characterized using the load-dependent example (naïve vs. post-dobutamine), observed mostly in case of rate of rise of LVP, LV ESP and decrease of pulse wave velocity, characteristics of LV baroinometry. Furthermore, by performing load-independent maneuver, afterload (LV ESP) was adjusting at every cardiac cycle, while an assessment of LV ESP and aortic valve timing was able to be established. By plotting decaying LV ESP against aortic valve timing, highly linear correlation of load-independent isotonic, but also an isometric contractility was captured. Steeper linear slope and time-axis intercept (IC) were identified in case of post-inotropic challenge, recapitulating changes otherwise measured during pressure-volume exam. This relationship, measured by dual-pressure catheter, could serve as novel inotropic index of functional cardiac contractility. Keywords: Left Ventricle (LV); Contractility; Inotropy; Load-Dependent and Independent; Stressed Volume; Dual Pressure Catheter. 1. Assessment of cardiac contractility using dual pressure catheter. 2. IVCO inferior vena cava occlusion, ECC excitation-contraction coupling, EF ejection fraction, TTE transthoracic echocardiography, Ea end arterial elastance, PRSW preload recruitable stroke work, IC intercept, PWV pulse wave velocity.
心肌收缩是在收缩期早期由于心室收缩而不改变容积,心室压力通过对关闭瓣膜的等距力而产生的。心脏周期的初始收缩阶段(早期收缩期)随后是快速缩短、等张收缩,允许血液在左室负荷变化时射出。左室与全身动脉压相关;因此左室射血与主动脉瓣、主动脉及其分布动脉的特性密切相关。使用负荷相关的例子(naïve vs.多巴酚丁胺后)来表征左室的等长关系,主要观察到左室血压升高,左室ESP和脉搏波速度下降的情况,左室气压测量的特征。此外,通过负荷无关的操作,后负荷(左室ESP)在每个心脏周期进行调整,同时可以建立左室ESP和主动脉瓣时间的评估。通过绘制衰减的左室电潜压与主动脉瓣授时的关系,我们不仅捕获了与负荷无关的等压性高度线性相关,还捕获了等距收缩性。在肌力刺激后发现了更陡峭的线性斜率和时间轴截距(IC),再现了在压力-容积检查中测量到的变化。通过双压导管测量这种关系,可以作为功能性心脏收缩力的新型肌力指标。关键词:左心室;收缩性;Inotropy;负载相关与独立;强调体积;双压导管。使用双压导管评估心脏收缩力。2. IVCO下腔静脉闭塞,ECC兴奋-收缩耦合,EF射血分数,TTE经胸超声心动图,Ea端动脉弹性,PRSW预负荷可征搏功,IC截距,PWV脉波速度。
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Journal of Cardiology and Clinical Management
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