正常入瓦沙瓦动作期间的左心室功能变化

• 作 者: 张象贤 徐浩仁 魏守德 张祖根
• 机 构: 上海医科大学附属金山医院内科,上海医科大学附属金山医院内科,上海医科大学附属金山医院内科,上海医科大学附属金山医院内科,
• 出 处: 心功能杂志
• 发表日期: 1992年02期
• 关键词: 左心室功能 心搏出量 血液动力学 舒张末期内径 动脉收缩压 心排量 心脏功能试验 左室功能 左心室壁 缩短率

采用心电阻抗图和超声心动图研究14例正常人血液动力学和左心室功能对瓦沙瓦(Valsalva)动作的反应。结果显示Ⅱ相时动脉收缩压下降,心率增快,心搏出量和心排量减少。Ⅳ相时收缩压显著增加,心搏出量和心排量也显著增加。Ⅱ相时左心室舒张末期内径显著减少,提示由于胸腔正压,使静脉回流减少。Ⅳ相尽管左心室壁张力显著增加,但心肌纤维缩短率得到维持,心搏出量增加,提示由于Ⅱ相时收缩压下降,反射性兴奋β-肾上腺素能受体,使心肌收缩力增强。

The responses of hemodynamics and left ventricular function to Valsalva motions in 14 normal subjects were studied using electrocardiogram and echocardiography. The results showed that systolic blood pressure decreased, heart rate increased, cardiac output and cardiac output decreased in phase Ⅱ. Ⅳ phase systolic blood pressure increased significantly, cardiac output and cardiac output also increased significantly. Ⅱ phase left ventricular end-diastolic diameter was significantly reduced, suggesting that as a result of positive pressure in the chest, venous return to reduce. Ⅳ phase despite a significant increase in left ventricular wall tension, but shortening the rate of myocardial fiber was maintained, increased cardiac output, suggesting that due to Ⅱ phase systolic blood pressure decreased, reflex β-adrenoceptors, myocardial contractility increased.