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室间隔对心功能作用的实验研究 |
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程芮 程显声 杨浣宜 杨俊玲 李永利 赵惠英 朱宜明 刘醒
【摘要】 目的 评价室间隔在维持心功能中的作用，特别是对右心功能的作用。方法 选择健康杂种犬7只，形成室间隔心肌梗塞动物模型，梗塞前后施加压力负荷即环缩肺动脉和环缩主动脉，应用超声心动图观察心功能的改变。结果 室间隔梗塞后左室收缩压及右室收缩功能明显降低。动脉携氧量及氧运输量减少。二尖瓣E/A减小，左室等容舒张时间间期延长；三尖瓣E/A<1。收缩期室间隔厚度及收缩期增厚率降低，左室游离壁收缩期增厚率增加，而右室游离壁变化不明显。同样程度的右室压力负荷、右室收缩压升高幅度明显低于梗塞前（P<0.01），且舒张压较前升高；同样程度的左室压力负荷，左室收缩压升高幅度较前降低（P<0.01），右室收缩压随之升高的幅度也降低（P<0.01）。结论 室间隔不仅参与了左心功能的维持，对右心功能的维持更重要。
【关键词】 室间隔 心功能 超声心动图描记术
Interventricular septum and cardiac function CHENG Rui, CHENG Xiansheng, YANG Huanyi, et al. Cardiovascular Institute and Fu Wai Hospital, PUMC and CAMS, Beijing 100037
【Abstract】 Objective To evaluate the effect of the interventricular septum (IVS) on the heart function, especially on the right heart performance. Methods By ligated the septal branches of left anterior descending coronary artery to form the model of IVS myocardial infarction, the ventricular interaction under pressure overload and the changes in heart functions were observed by echocardiography. Results After IVS infarction, left ventricular end-systolic pressure and right ventricular cardiac output decreased followed by oxygen delivery and transportation reduction(P<0.05; P=0.089). Although the E/A of mitral valve was more than 1, it decreased dramatically compared to the pre-infarction and the E/A<1 of tricuspid valve. The isovolumic relaxation time (IVRT) of left ventricle prolonged significantly (107.3±45.9 ms vs 194.2±45.8 ms, P<0.01). The systolic thickness and systolic thickened rate of IVS decreased, while the systolic thickened rate of left ventricular free wall increased but it had no changes in the right ventricular free wall. With the same degree of PAC and AC, the increment of right ventricular end-systolic pressure went under the degree of pre -infarction accompanied by the elevation of end-diastolic pressure and similarly to the affection of during AC. Conclusion IVS is not only a part o[1] [2] 下一页
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