在患有和没有充血性心力衰竭的患者中,收缩和放松是否相结合?
E J Eichhorn1, J E Willard, L Alvarez
1Cardiac Catheterization Laboratory, Dallas Veterans Administration Hospital, Tex.
Circulation
|June 1, 1992
概括
心脏收缩和放松在生理上是相互关联的,随着收缩能力的下降,放松在心力衰竭中迅速恶化. 无论是β阻塞剂还是数字化药物都保持了这种合,为心力衰竭治疗提供了洞察力.
科学领域:
- 心脏病学 心脏病学
- 生理学 生理学 生理学
- 生物医学工程 生物医学工程
背景情况:
- 腹腔收缩和放松变化往往相互关联,但缺乏这种腹腔合的数学模型.
- 一个拟议的模型表明,收缩和放松测量之间存在过度的关系.
- 这项研究测试了是否与负载独立的收缩率 (末缩弹性,Ees) 和放松率 (tau-to-end-systolic压力关系的斜率,R) 的测量相结合.
研究的目的:
- 为了验证描述心室收缩和放松之间的超标关系的数学模型.
- 为了调查像β阻塞和数字这样的干预措施是否会影响这种合.
- 确定这种合在心力衰竭中的临床影响.
主要方法:
- 在30名受试者中评估了Ees和R,使用数字腹腔镜和微观压力测量.
- 为了评估负载依赖性,施用了分级剂量的化.
- 研究了β-阻塞 (cAMP介导) 和deslanoside (cAMP独立) 对患者子集合的影响.
- 使用非线性回归分析来建模Ees-R关系.
主要成果:
- 确定了一个过度的关系 (Ees * R = 1.05,r = 0.79,p < 0.001),在Ees = 1.02 mm Hg/ml的拐点.
- 正常的收缩性显示出正常,负载独立的放松 (R ≈ 0).
- 系统性功能障碍导致负载依赖性放松.
- 贝塔阻塞改善了收缩性和放松性,但没有改变合;德斯拉诺赛德改善了两者,但也保持了合.
- 在R的变化大小取决于药物前的R值.
结论:
- 收缩和放松在生理上是相互关联的,在早期心力衰竭中保持放松,随着弹性降至1.02mm Hg/ml以下,放松会恶化.
- 通过不同的机制,β阻塞剂和数字化药物可以改善收缩性和放松性,同时保持合.
- 过度合模型对心力衰竭治疗选择和临床试验设计有重大影响.
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