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交互脈 또는 心室性二投脈 誘發에 따른 心搏出量 變化에 관하여

STUDIES ON THE CARDIAC OUTPUT WHEN PULSES ALTERNANS OR VENTRICULAR BIGEMINY WAS INDUCED IN DOGS

대한의학협회지 1969년 12권 6호 p.610 ~ 616
김근주, 呂雄淵,
소속 상세정보
김근주 (  ) - 경북대학교 의과대학 생리학교실
呂雄淵 (  ) - 慶北大學校 醫科大學 生理學敎室

Abstract


At the present time, majority of clinicians believe that the pulsus alternans which frequently develops in patients with chronic or acute serious heart disease, is a sign of heart failure. However, the question whether or not the pulsus alternans itself significantly reduces circulatory efficiency remains unclarified yet, since the phenomenon of pulsus alternans is recently proved to be producible by simply increasing the artificially driven heart rate in intact dog heart and in papillary muscle.
The present study was attempted to pursue the possible change of the cardiac output following the development of the pulsus alternans or of the ventricular bigeminy in dogs. The pulsusalternans was induced by increasing the heart rate, driving the heart with stimulator using two electrodes one of which was placed with the aid of cardiac catheter into right atrium via jugular vein and the other electrode attached to 18 gaze spinal needle was inserted into the thoracic cavity to the near of the right atrium. The ventricular bigeminy was induced by rapid intravenous administration of sodium thiopental.
The cardiac out put was measured according to direct Fick principle in control dogs and in pulsus alternans or bigeminy induced dogs.
The results obtained are summarized as follows:
1. The cardiac out put measured after the ventricular bigeminy was induced on 7 observations in 5 dogs with negligible change in heart rate, showed no difference comparing with the control value.
2. In 8 dogs in which pulsus alternans was induced by increasing heart rate from average of 170 per minutes in control state to average of 290 per minute, the cardiac output was decreased to about 77% of the control value. And in control dogs, the cardiac output showed a tendency of inversely proportionate to the increase in heart rate when the heartrate exceeded above 180 per minute.
3. The tendency of decrease in cardiac output following the development of the pulsus alternans by rapider driving, was seemed due to increased heart rate above the physiological range. It is concluded that the phenomenon of pulsus alternans by itself does not affect the cardiac output significantly.

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