EFFECT OF AFTERLOAD ON THE LEFT VENTRICULAR PRESSURE FALL DURING ISOVOLUMIC RELAXATION PERIOD IN MAN

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To assess the effect of afterload on the left ventricular pressure (LVP) fall during isovolumic relaxation period (IRP) in man, we examined the peak (-)dP/dt, (-)dP/dt upstroke pattern if IRP, and time constant (T) in 15 patients [normal (N) : 5, valvular heart disease (VHD) : 5, dilated cardiomyopathy (DCM) : 5]. LVP and echocardiographic internal diameter were measured simultaneously at rest and after about 30 mmHg increment of LV peak systolic pressure (PSP) by drip infusion of angiotensin (20 ng/kg/min). After augmentation in afterload, heart rate (HR) increased slightly in VHD. T increased significantly (p < 0.05) in N (from 32 ± 3 to 39 ± 4 ms) and DCM (from 56 ± 18 to 72 ± 12 ms), but not in VHD (from 41 ± 5 to 46 ± 8 ms) probably due to increased HR. LV end-systolic dimension had the same trend as T. Although there was no significant change in peak (-)dP/dt in N (from 1937 ± 385 to 1945 ± 189 mmHg/s), VHD (from 1521 ± 210 to 1730 ± 462 mmHg/s), or DCM (from 814 ± 143 to 814 ± 131 mmHg/s), the (-)dP/dt upstroke pattern during IRP became nonexponential in N and more downward convex in VHD or DCM. Thus, these changes of T and (-)dP/dt upstroke pattern suggest the afterload dependence of LVP fall during IRP in normal and diseased hearts.
社団法人日本循環器学会の論文
1988-06-20