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La elasticidad arterial efectiva como índice de la carga vascular arterial en humanos
R P Kelly1, C T Ting, T M Yang
1Department of Internal Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Circulation
|August 1, 1992
Resumen
La elasticidad arterial efectiva (Ea), calculada como la presión sistólica final al volumen del trazo, mide con precisión la carga arterial en humanos. Este método simple, Ea(PV), está validado para evaluar los impactos en el rendimiento cardíaco por el envejecimiento y la hipertensión.
Área de la Ciencia:
- Fisiología cardiovascular fisiología cardiovascular.
- Ingeniería Biomédica Ingeniería Biomédica.
- La hemodinámica clínica es la hemodinámica.
Sus antecedentes:
- La carga arterial tiene un impacto significativo en el rendimiento cardíaco.
- La evaluación precisa de la carga arterial es crucial para comprender la salud cardiovascular, especialmente en las poblaciones de envejecimiento e hipertensión.
Objetivo del estudio:
- Para validar la relación simple entre la presión sistólica ventricular terminal y el volumen del golpe (Ea(PV)) como una medida de la carga arterial.
- Para comparar Ea(PV) con las medidas de carga arterial derivadas de la impedancia de entrada aórtica (Ea(Z)).
- Evaluar el impacto del envejecimiento y la hipertensión en la carga arterial y sus efectos en el ventrículo.
Principales métodos:
- Medida simultánea de los bucles de presión-volumen ventricular y la presión y el flujo aórtico invasivo en sujetos humanos.
- Comparación de dos medidas de carga arterial: Ea(Z) derivado de un modelo de Windkessel y Ea(PV) de la presión sistólica final / volumen de golpe.
- Prueba de métodos simples para estimar el Ea (PV) a partir de las presiones arteriales de rutina.
Principales resultados:
- Ea (PV) y Ea (Z) mostraron una fuerte correlación (r2 = 0,98) a través de varias condiciones fisiológicas.
- Ea(PV) refleja con precisión la carga arterial, superando la resistencia arterial media en sujetos hipertensivos mayores debido a la reducción del cumplimiento y los reflejos de onda.
- Métodos simples validados para la estimación de Ea (PV) a partir de mediciones rutinarias de la presión arterial.
Conclusiones:
- La relación entre la presión sistólica terminal y el volumen del trazo (Ea(PV)) es un método conveniente y válido para evaluar la carga arterial.
- Ea(PV) explica mejor los efectos de la carga pulsátil en el ventrículo causados por el envejecimiento y la hipertensión que la resistencia arterial media.
- Este método proporciona información valiosa sobre el rendimiento cardíaco en condiciones de mayor carga arterial.
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