RESUMEN
In order to evaluate the importance of the indices of ventricular rigidity and compliance (k=dP/dV.P and dV/dP), three groups of patients were studied and compared. A simplified method of calculating the diastolic compliance made use of the values of end-diastolic volume (EDV) measured by cineangiography, and of end-diastolic pressure (EDP), using the assumption that the relationship P-V is an exponential one arising from the ordinate: 0.43 mmHg. The correlation between EDP and EDV, which was positive in 19 coronary artery patients, was in fact negative in 11 patients with obstructive cardiomyopathy (OCM), and insignificant in 12 control patients. There were multiple correlations between k, EDPs and EDVs in 11 OCMs, and none in the two other groups. The ratio dV/dP decreased in end-diastole both in the OCM group and in the coronary group, and did not reflect the difference in pathology between these two groups. On the other hand k was increased in the patients with OCM, normal in the coronary patients, and represented in the former a primary modification in the relationship P-V and a primary increase in diastolic rigidity.
Asunto(s)
Gasto Cardíaco , Cardiomiopatías/fisiopatología , Enfermedad Coronaria/fisiopatología , Corazón/fisiopatología , Contracción Miocárdica , Adaptabilidad , Corazón/fisiología , PresiónRESUMEN
A cine-angiographic study was carried out in eleven patients with major aortic incompetence, in two of whom there was an associated aortic stenosis. The ventricular end-diastolic volume is always greatly increased, disproportionately to the modest increase in end-diastolic pressure. The pressure-volume relationship during filling is therefore altered, and makes it possible for a normal end-diastolic compliance (dV/dP) TD to be preserved. The indices of contractility are markedly altered, despite the recent appearance of signs of poor tolerance. These findings argue in favour of a full haemodynamic investigation and of early corrective surgery.