右心室容积循环变化对电导导管测量左心室力学参数的影响。

Y. Tanoue, Shigeki Morita, M. Hisahara, Ryuji Tominaga, Yoshito Kawachi, Hisataka Yasui
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引用次数: 6

摘要

导流导管广泛应用于左室压力-容积循环的连续测量。右心室容积的周期性变化可能改变平行电导容积,从而影响左室力学参数。8只开胸成年杂种犬,采用两种方法获得多个左室压力-容积环路:一种是腔静脉闭塞法(VCO),这涉及到右室容积的改变;另一种是右心旁路(RHB)准备,这是完全减压的右心室。从每个循环中计算收缩期末期压力-容积关系的斜率(Ees)、收缩期末期压力为100 mmHg时的收缩期末期容积(V100,es)、刚度常数(beta)和舒张末期压力为9 mmHg时的舒张末期容积(V9,ed)。左心室容积改变对收缩期指标的影响最小[Ees (VCO法),6.37 +/- 1.91 mmHg/ml;RHB制剂,6.60 +/- 1.66mmHg/ml;p=0.356), V100,es (VCO法,18.4±9.3ml;RHB制剂,17.8 +/- 9.0 ml;p=0.681)],但对舒张期指标有显著影响[β (VCO法,0.0599 +/- 0.0152;RHB制剂,0.0839 +/- 0.0150;p=0.007), V9,ed (VCO法,35.6±11.3 ml;RHB制剂,31.9 +/- 12.3 ml;p = 0.001)。舒张期左室容积增大,平行电导容积增大,导致电导导管测量的左室舒张容积高估。
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Influence of cyclic variation of right ventricular volume on left ventricular mechanical parameters measured with conductance catheter.
The conductance catheter is widely used for the continuous measurement of the left ventricular (LV) pressure-volume loops. Cyclical change of the right ventricular (RV) volume may alter the parallel conductance volume, thereby affecting the LV mechanical parameters. Using 8 open-chest adult mongrel dogs, multiple LV pressure-volume loops were obtained by 2 methods: first with a vena cava occlusion (VCO) method, which involved RV volume alteration, and second with a right-heart-bypass (RHB) preparation, which decompressed the right ventricle completely. The slope of the end-systolic pressure-volume relation (Ees), the end-systolic volume associated with the end-systolic pressure of 100 mmHg (V100,es), stiffness constant (beta), and the end-diastolic volume associated with the end-diastolic pressure of 9 mmHg (V9,ed) were calculated from each loop. There was minimal influence from RV volume alteration on systolic-phase indices [Ees (VCO method, 6.37 +/- 1.91 mmHg/ml; RHB preparation, 6.60 +/- 1.66mmHg/ml; p=0.356), and V100,es (VCO method, 18.4 +/- 9.3ml; RHB preparation, 17.8 +/- 9.0 ml; p=0.681)], but there was a significant influence on diastolic-phase indices [beta (VCO method, 0.0599 +/- 0.0152; RHB preparation, 0.0839 +/- 0.0150; p=0.007), and V9,ed (VCO method, 35.6 +/- 11.3 ml; RHB preparation, 31.9 +/- 12.3 ml; p=0.001)]. The increase in the RV volume in the diastolic phase increased the parallel conductance volume, causing overestimation of the LV diastolic volume measured by the conductance catheter.
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