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首页> 外文期刊>American Journal of Physiology >Determinants of LV diastolic function during atrial fibrillation: beat-to-beat analysis in acute dog experiments.
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Determinants of LV diastolic function during atrial fibrillation: beat-to-beat analysis in acute dog experiments.

机译：心房颤动期间左室舒张功能的决定因素：急性狗实验中的逐搏分析。

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Left ventricular (LV) diastolic function during atrial fibrillation (AF) remains poorly understood due to the complex interaction of factors and beat-to-beat variability. The purpose of the present study was to elucidate the physiological determinants of beat-to-beat changes in LV diastolic function during AF. The RR intervals preceding a given cardiac beat were measured from the right ventricular electrogram in 12 healthy open-chest mongrel dogs during AF. Doppler echocardiography and LV pressure and volume beat-to-beat analyses were performed. The LV filling time (FT) and early diastolic mitral inflow velocity-time integral (E(vti)) were measured using the pulsed Doppler method. The LV end-diastolic volume (EDV), peak systolic LV pressure (LVP), minimum value of the first derivative of LV pressure curve (dP/dt(min)), and the time constant of LV pressure decay (tau) were evaluated with the use of a conductance catheter for 100 consecutive cardiac cycles. Beat-to-beat analysis revealed a cascade of important causal relations. LV-FT showed a significant positive linear relationship with E(vti) (r = 0.87). Importantly, there was a significant positive linear relationship between the RR interval and LV-EDV in the same cardiac beat (r = 0.53). Consequently, there was a positive linear relationship between LV-EDV and subsequent peak systolic LVP (r = 0.82). Furthermore, there were significant positive linear and negative curvilinear relationships between peak systolic LVP and dP/dt(min) (r = 0.95) and tau (r = -0.85), respectively, in the same cardiac beat. In addition, there was a significant negative curvilinear relationship between dP/dt(min) and tau (r = -0.86). We have concluded that the determinants of LV diastolic function in individual beats during AF depend strongly on the peak systolic LVP. This suggests that the major benefit of slower ventricular rate appears related to lengthening of LV filling interval, promoting subsequent higher peak systolic LVP and greater LV relaxation.
机译：心房颤动（AF）期间左心室（LV）舒张功能的了解仍然很差，原因是因素之间的复杂相互作用和心跳之间的变异性。本研究的目的是阐明房颤期间LV舒张功能逐跳变化的生理决定因素。在AF期间，通过12只健康的开胸杂种狗的右心室电图测量了给定心跳之前的RR间隔。进行了多普勒超声心动图，左室压力和逐搏分析。使用脉冲多普勒方法测量左室充盈时间（FT）和舒张早期二尖瓣血流速度-时间积分（E（vti））。评估左室舒张末期容积（EDV），收缩期左室压力峰值（LVP），左室压力曲线一阶导数的最小值（dP / dt（min））和左室压力衰减的时间常数（tau）使用电导导管连续100个心动周期。逐项分析显示出一系列重要的因果关系。 LV-FT与E（vti）呈显着正线性关系（r = 0.87）。重要的是，在相同的心跳中，RR间隔和LV-EDV之间存在显着的正线性关系（r = 0.53）。因此，LV-EDV与随后的收缩期峰值LVP之间存在正线性关系（r = 0.82）。此外，在相同的心跳中，收缩压峰值LVP与dP / dt（min）（r = 0.95）和tau（r = -0.85）之间分别存在显着的正线性和负曲线关系。此外，dP / dt（min）与tau之间存在显着的负曲线关系（r = -0.86）。我们已经得出结论，房颤期间单个搏动中LV舒张功能的决定因素强烈取决于收缩期LVP峰值。这表明降低心室率的主要好处似乎与延长左室充盈间隔，促进随后的更高的收缩压峰值LVP和更大的左室舒张有关。

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