急性低氧下钙阻断剂对左,右心泵功能的影响

在20条麻醉开胸狗上,用RM-6000多道仪同步记录左心室内峰压(LVP)、左室压力变化率(L+dP/dt_(max))、右心室内峰压(RVP)、右室压力变化率(R±dp/dt_(max))、肺动脉压力(P_(Pa))、主动脉血流每搏峰值(Fa)、心率(HR)等各项生理指标,观察钙通道阻断剂Nife-dipine,Diltiazem和Verapamil对左、右心室功能影响。在钙通道阻断剂处理后,左室的LVP,L±dp/dt_(max)下降,而Fa增加;右室的RVF,R±dp/dt_(max)和P_(Pa)均有升高趋势,显示钙通道阻断剂对左、右心泵功能的影响不同。这可能提示左、右心室功能对钙离子的依赖程度不同。在急性低氧状态下,此三种钙阻断剂均使急性低氧引起LVP的增加反应消失,Fa增加明显,Verapamil和Diltiazem有减轻急性低氧引起的RVP和P_(Pa)的增压作用。从这些钙通道阻断剂对左右心泵功能影响的比较来看,Diltiazem比Verapamil和Nifedipine对急性低氧状态下的心泵功能有较好的作用。

EFFECTS OF CALCIUM BLOCKERS ON THE PERFORMANCE OF LEFT AND RIGHT VENTRICLES DURING ACUTE HYPOXIA

In anesthetized and thoracotomized 20 adult dogs under artificial respiration, the effects of calcium blockers (nifedipine, diltiazem and verapamil) on the mechanics of the left and right cardiac pumps under acute hypoxia were observed. The left and right ventricular pressure (LVP and RVP) and their dp/dt (+/- dp/dtmax), aortic flow (Fa), pulmonary pressure (Ppa) and heart rate (HR) were recorded. After treatment with calcium blockers, LVP and L +/- dp/dtmax decreased, and Fa increased, while RVP, R +/- dp/dtmax and Ppa all tended to increase. These results showed that the effects of calcium blockers on the performance of the left and right ventricles were different, suggesting that the dependence of left and right myocardium on calcium was different in degree. The mechanics of the left and right ventricles responded differently to calcium blockers under acute hypoxia. After treatment with calcium blockers, pressor responses on LVP by acute hypoxia disappeared. There was a great increase in Fa. Decrease in pressor response of RVP and Ppa was also observed in acute hypoxic dogs receiving verapamil and diltiazem. Comparing the effects of nifedipine, diltiazem and verapamil on the mechanics of the left and right cardiac pumps under acute hypoxia, it appears that diltiazem exerts beneficial effect on the performance of cardiac pump under acute hypoxia.