心脏搏动做功规律研究（英文）

To studythe law of the heart working

目的研究心脏搏动做功的规律,质疑Frank-Starling心脏定律。方法根据物理学机械做功的定义,以左心室收缩射血做功为模型对心脏收缩舒张做功活动进行讨论,然后用数学方法得出结论。结果 1作者推导出计算vvvv心脏每搏收缩舒张做功的公式"d d W=∫p1dv+(-p2)d d dv+(-p4)dV=[P1+(-P2)+P3+(-P4)]·V vs∫vs∫p3dv+vs∫vs=[P1+(-P2)+P3+(-P4)]·(EDV-ESV)"(式中,P1,P3分别代表心脏收缩时左、右心室腔内的压力;P2,P4为心脏舒张期左、右心室腔内的压力;V为每搏量;Vs和Vd为心脏收缩开始和结束,即:心脏收缩舒张做功时心室肌壁移动的区间;EDV和ESV为心脏舒张末期与收缩末期容积;dv为射出或吸入心室的血液容积增量)。2局部心室肌壁收缩做功与其肌壁收缩移动时的"ah"值成正比例(a为心脏收缩时局部心室肌壁位移动的加速度,h为其收缩时的位移)。结论 1在推导出的公式"W=[P1+(-P2)+P3+(-P4)]·(EDV-ESV)"中,心脏做功W和(EDV-ESV)与EDV三者之间的数学关系表明:W是(EDV-ESV)的函数,和单一参数EDV却没有函数关系,这就证明了心脏做功W是EDV的函数的理论(Frank-Starling心脏定律)没有理论上的必然性,它不是一个真实的定律。2超声检测某一点心室肌壁收缩活动时的"ah"值,可作为评价其心脏收缩功能的指标;舒张时的"ah"值可作为评价其舒张功能的指标。

Objective The law of the heart working is studied,and the Frank-Starling Law of the Heart is questioned.Methods According to the definition of the mechanical work in physics,the heart working in systole and diastole is discussed with a model of the left ventricular systolic ejection of blood doing work,and then mathematically our conclusions are drawn.Results 1 The formula for calculating the heart working in systole and diastole is deduced as follows：vvvvd d d d W=∫p1dv＋dv＋vs∫（-p2）vs∫p3dv＋p4）dv=[P1＋（-P2）＋P3＋（-P4）]·V=[P1＋（-P2）＋P3＋（-P4）]·（EDV-ESV）.vs∫（-vs In the formula,P1 and P3stand for the left and right ventricular pressure respectively during systole;P2and P4--the left and right ventricular pressure respectively during diastole;V--the stroke volume;Vdand VS--the start and end position of the ventricular contraction,range of the ventricular wall moving during the heart working;EDVand ESV--the end diastolic and systolic volume;Under P（pressure）each increment（dv）of the Vis ejected or suctioned.2 The amount of the locul myocardium working is in direct proportion to the＂ah＂value of the ventricular muscle wall moving at one point during systole（＂a＂--the acceleration of the heart muscle wall moving during systole;＂h＂--the displacement of the ventricular wall）.Conclusion 1 Formula for calculating the heart working in systole and diastole ＂[P1＋（-P2）＋P3＋（-P4）]·V=[P1＋（-P2）＋P3＋（-P4）]·（EDV-ESV）＂is deduced,in which the mathematical relationship between the W and（EDV-ESV）and EDVshows that the heart working W is a function of the（EDV-ESV）,and there is no functional relation between the W and EDV.However,the Frank-Starling Law of the Heart asserts that the EDVbe isolated from the（EDV-ESV）.Evidently,it has no theoretical necessity and is not a true law.2 ＂ah＂value in ultrasonic detection of the ventricular muscle wall moving at one point during systole can be used as an evaluation index of the systolic function,and the＂ah＂value in diastole can be used as an evaluation index of the diastolic function.