在异常性缩性心肌病症中,动态和被动的透析压力-体积关系之间的明显不一致
P H Pak1, L Maughan, K L Baughman
1Department of Internal Medicine, Division of Cardiology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Circulation
|July 1, 1996
概括
异常性多变性心肌病 (HCM) 患者表现出明显的透支压力-体积曲线,与被动关系显著不同. 这表明HCM中加高的填充压力受到负载条件的影响,而不仅仅是腔体刚性.
科学领域:
- 心脏病学 心脏病学
- 心血管生理学心血管生理学
- 生物医学工程 生物医学工程
背景情况:
- 异常性多变性心肌病 (Idiopathic hypertrophic cardiomyopathy,HCM) 呈现出比预期的较浅的动态透气压力-体积曲线,而不是高室度.
- 这项研究调查了HCM中压力-体积填充曲线和被动终端透气压力-体积关系 (EDPVR) 之间的不一致性.
研究的目的:
- 在HCM患者中探索动态透析压力-体积曲线与被动EDPVR背后的偏差机制.
- 为了比较HCM中的压力-体积动态与正常受试者,高血压增大和扩张性心肌病.
主要方法:
- 在42名患者中,使用了侵入性压力-体积分析和导电性导管导管方法.
- 在下静脉内流入阻塞期间记录了终端透气压力-体积关系 (EDPVR).
- 其中9名患者患有HCM,11名患者的LV功能正常,13名患者患有LVH-HTN,9名患者患有DCM.
主要成果:
- HCM患者表现出明显的,平坦的压力-体积填充 (PVR填充) 曲线,与其的EDPVR显著不同.
- 相比之下,正常,LVH-HTN和DCM组在PVR填充和EDPVR之间显示出最小的偏差.
- HCM PVR填充曲线平行向下移动,预负荷减少 (-10+/-4 mm Hg),与其他组不同 (-2+/-2 mm Hg; P<.001).
结论:
- 在HCM中,左心室 (LV) 填充压力升高受到负载依赖的偏移压力的影响,而不仅仅是腔内硬度.
- 动态填充和被动EDPVR之间的显著差异似乎是HCM的独特之处.
- 从稳定状态数据中解释刚度需要谨慎;针对几何和相互作用的疗法可能会影响HCM中LV透气压.
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