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首页> 外文期刊>International heart journal >Right Ventricular End-Diastolic Pressure Is a Key to the Changes in Cardiac Output During Adaptive Servo-Ventilation Support in Patients With Heart Failure Clinical Relevance of Transmural Left Ventricular Filling Pressure
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Right Ventricular End-Diastolic Pressure Is a Key to the Changes in Cardiac Output During Adaptive Servo-Ventilation Support in Patients With Heart Failure Clinical Relevance of Transmural Left Ventricular Filling Pressure

机译：右心室末端舒张压是心力衰竭患者患者患者左心室灌注压力患者的适应性伺服通风载体变化的关键

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摘要

Adaptive servo-ventilation (ASV) is a recently-developed non-invasive therapy that improves the clinical course of heart failure (HF) patients. However, the precise hemodynamic response and predictors of ASV therapy remain uncertain. Overall, 69 patients with New York Heart Association HF class II-IV underwent 10-minute ASV testing along with hemodynamic studies. Among them, 21 (30%) achieved an acute response, which was defined as an increase in the cardiac index (CI) during ASV. Delta Left ventricular end-diastolic pressure (LVEDP) did not correlate with Delta CI, whereas Atransmural LVEDP, which was calculated by subtracting right ventricular end-diastolic pressure (RVEDP) from LVEDP, and Delta CI were positively correlated, similar to the ascending limb of Frank-Starling's law (P = 0.009, r = 0.311). Among baseline data, higher RVEDP and higher LVEDP were significant predictors of an acute response by logistic regression analyses (P < 0.05 for both). RVEDP had a significantly higher area under the curve than LVEDP in the receiver operating characteristic analyses (0.846 versus 0.673, P = 0.028). Higher baseline RVEDP was significantly associated with a greater decrease in RVEDP during ASV (P < 0.001, r =-0.604). In conclusion, in HF patients with elevated RVEDP, ASV increased cardiac output through a decrease in RVEDP and an increase in transmural LVEDP, according to the ascending limb of Frank-Starling's law.
机译：自适应伺服通风（ASV）是最近开发的非侵入性治疗，可提高心力衰竭（HF）患者的临床进程。然而，ASV疗法的精确血液动力学反应和预测因子仍然不确定。总体而言，69例纽约心脏协会患者HF II-IV级接受了10分钟的ASV测试以及血液动力学研究。其中，21（30％）达到急性反应，其定义为ASV期间的心脏指数（CI）的增加。 Delta左心室舒张压（LVEDP）与δCI不相关，而通过从LVEDP中减去右心室舒张舒张压（RVEDP）来计算的ATRASMURARLVEDP，并且ΔCI是正相关的，类似于上升的肢体Frank-Starling的法律（p = 0.009，r = 0.311）。在基线数据中，较高的RVEDP和更高的LVEDP通过Logistic回归分析是急性反应的显着预测因子（两者都是P <0.05）。 RVEDP在接收器操作特征分析中的曲线下具有明显高的区域（0.846对0.673，P = 0.028）。在ASV期间，较高的基线RVEDP与RVEDP的更大减少显着相关（p <0.001，r = -0.604）。总之，根据Frank-Starling法律的升级，ASV通过RVEDP的减少增加了ASV增加了心输出，并增加了透气率的透气率。

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