[有心包和无心包的心室功能曲线:心包压力分析]。

E Lupi-Herrera, H González Pacheco, C Martínez Sánchez, L A Lasses y Ojeda, U Juárez Herrera, E Chuquiure Valenzuela, M C López Rodríguez, M Rosas Peralta, M Patiño
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引用次数: 0

摘要

同时获得犬模型(开胸准备)有心包和无心包的左右心室功能曲线(VFC, R, L)。控制左、右心室的预负荷和后负荷条件。心室舒张末期压力为0至25 mmHg,心输出量为50至250 mL/kg-1min-1。在低填充压力下,左、右VFC均表现出最初的急剧上升,然后在高填充压力下趋于平稳。有心包和无心包情况下VFC的最佳数学模型为抛物线模型(r2分别为0.71、0.72)。心包切除术后,左心室和右心室随心包移位至左心室,在心排血量的同一点充血压力下降,提示心包有抑制作用。在相同的心输出量水平下,通过减去无心包的心包填充压力,得出心包压力。在所有VFC范围内,心包压均为正,且随着心输出量的增加,心包压升高。因此,左、右心室的跨壁压力从未为零。从二阶多项式方程得出的R和L充盈压力的关系表明,在正常充盈压力下,心包的影响很小,但并非不重要,而在高心排血量时,心包的影响非常大。在心包压力的动态入路中,小影响和主要影响之间的界限出现在正常充盈压力的上限。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Ventricular function curves with and without pericardium: analysis of pericardial pressures].

Simultaneous right and left ventricular function curves (VFC, R, L) were obtained in a canine model, (open chest preparation), with and without pericardium. Preload and afterload conditions for the right and left ventricles were controlled. VFC were constructed from zero to 25 mmHg of ventricular end-diastolic pressures and by increasing the cardiac output from 50 to 250 mL/kg-1min-1. Both, right and left VFC showed an initial steep rise at low filling pressures and then flattened off to a plateau at high filling pressures. The best mathematical model that fitted with the VFC, with and without the pericardium was the parabola (r2 = 0.71, 0.72 respectively). After pericardiectomy R and L VFC were displaced to the left of the VFC with pericardium and a decrease in filling pressures were noted at the same points of cardiac output, findings that suggest a restraining effect of the pericardium. By subtracting the filling pressures obtained with pericardium from those without pericardium at the same levels of cardiac output, pericardial pressures were derived. In all the range of the VFC the pericardial pressures were positive, and this pressure increase as cardiac output increase. Thus the transmural pressure was never cero, for both right and left ventricles. The observed relation for the R and L filling pressures, derived from a polynomial equation of second order suggest a small although not unimportant effect of the pericardium at normal filling pressures, and a very substantial influence at high levels of cardiac output. The demarcation between small and major effects appears in the upper range of normal filling pressures in this dynamic approach of the pericardial pressures.

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