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首页> 外文期刊>American Journal of Physiology >Mechanics of intraventricular filling: study of LV early diastolic pressure gradients and flow velocities.
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Mechanics of intraventricular filling: study of LV early diastolic pressure gradients and flow velocities.

机译：心室充盈的力学：研究左室早期舒张压梯度和流速。

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摘要

This study investigates mechanisms of left ventricular (LV) intracavitary flow during early, rapid filling. In eight coronary artery disease patients with normal LV ejection fraction we recorded simultaneous LV apical and outflow tract pressures and intraventricular flow velocities by color M-mode Doppler echocardiography. In five anesthetized dogs we also recorded left atrial pressure and LV volume by sonomicrometry. In patients, as the early diastolic mitral-to-apical filling wave arrived at the apex, we observed an apex-outflow tract pressure gradient of 3.5 +/- 0.3 mmHg (mean +/- SE). This pressure gradient correlated with peak early apex-to-outflow tract flow velocity (r = 0.75, P < 0.05). The gradient was reproduced in the dog model and decreased from 3.1 +/- 0.3 to 1.7 +/- 0.5 mmHg (P < 0.05) with caval constriction and increased to 4.2 +/- 0.5 mmHg (P < 0.001) with volume loading. The pressure gradient correlated with peak early transmitral flow (expressed as time derivative of LV volume; r = 0.95) and stroke volume (r = 0.97). In conclusion, arrival of the early LV filling wave at the apex was associated with a substantial pressure gradient between apex and outflow tract. The pressure gradient was sensitive to changes in preload and correlated strongly with peak early transmitral flow. The significance of this gradient for intraventricular flow propagation in the normal and the diseased heart remains to be determined.
机译：这项研究调查早期，快速充盈期间左心室（LV）腔内流动的机制。在八名左室射血分数正常的冠状动脉疾病患者中，我们通过彩色M型多普勒超声心动图记录了同时的左室顶端和流出道压力以及心室内流速。在五只麻醉的狗中，我们还通过体测法记录了左心房压力和左室容量。在患者中，当舒张早期二尖瓣至心尖的充盈波到达顶点时，我们观察到的顶点流出道压力梯度为3.5 +/- 0.3 mmHg（平均+/- SE）。该压力梯度与峰值早期顶点到流出通道的流速相关（r = 0.75，P <0.05）。该梯度在狗模型中再现，并随着腔收缩而从3.1 +/- 0.3 mmHg降低至1.7 +/- 0.5 mmHg（P <0.05），并随着体积加载而增加至4.2 +/- 0.5 mmHg（P <0.001）。压力梯度与峰值早期传输流量（表示为LV体积的时间导数; r = 0.95）和每搏量（r = 0.97）相关。总之，早期的左室充盈波到达根尖与根尖和流出道之间的明显压力梯度有关。压力梯度对预紧力的变化很敏感，并且与峰值早期传输流量密切相关。该梯度对于在正常心脏和患病心脏中脑室内血流传播的意义尚待确定。

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