Ventricle

Fig. 2. Schematic of the human heart, showing the four chambers and various values. The atria act as receiving chambers and the ventricles act as...

One of the remarkable features of the heart, which is about the size of a fist, is that the pumping action or contractions (- 70 times/min) of atria and ventricles are simultaneous. Deoxygenated blood is pumped out to the lungs from one side of the heart at the same time oxygenated blood is pumped out from the other side to the aorta and onward through the body. The entire process of blood flow between the atria, ventricles, and the principal vessels is in unison, controlled in part by four one-way valves. The atrioventricular valves, tricuspid on the right and mitral on the left, prevent blood from flowing... 

Valve Problems. The primary solution to valve problems has been implantable replacement valves. The introduction of these devices necessitates open-heart surgery. There are two types of valves available tissue (porcine and bovine) and mechanical. The disadvantage of tissue valves is that these have a limited life of about seven years before they calcify, stiffen, and have to be replaced. The mechanical valves can last a lifetime, but require anticoagulant therapy. In some patients, anticoagulants may not be feasible or may be contraindicated. Of the valves which require replacement, 99% are mitral and aortic valves. The valves on the left side of the heart are under much greater pressure because the left ventricle is pumping blood out to the entire body, instead of only to the lungs. Occasionally, two valves are replaced in the same procedure. 

In contrast, the total artificial heart (TAH) is designed to overtake the function of the diseased natural heart. While the patient is on heart—lung bypass, the natural ventricles are surgically removed. Polyurethane cuffs are then sutured to the remaining atha and to two other blood vessels that connect with the heart. 

One successful total artificial heart is ABIOMED s electric TAH. This artificial heart consists of two seamless blood pumps which assume the roles of the natural heart s two ventricles (Fig. 7). The pumps and valves are fabricated from a polyurethane, Angioflex. Small enough to fit the majority of the adult population, the heart s principal components are implanted in the cavity left by the removal of the diseased natural heart. A modest sized battery pack carried by the patient suppHes power to the drive system. Miniaturized electronics control the artificial heart which mns as smoothly and quietly as the natural heart. Once implanted, the total artificial heart performs the critical function of pumping blood to the entire body (6). 

Ringer s Lactate. In 1883, it was discovered that the excised ventricle of the frog would beat for some hours if suppHed with an aqueous solution of sodium, potassium, and calcium salts. The concentration of potassium and calcium was found to be critical, whereas the amounts of the anions had htde effect on the frog heart. The composition of this saline, coined Ringer s solution, is given in Table 1. Many years later it was shown to be very close to that of frog plasma. 

The Cardiac Cycle. The heart (Eig. lb) performs its function as a pump as a result of a rhythmical spread of a wave of excitation (depolarization) that excites the atrial and ventricular muscle masses to contract sequentially. Maximum pump efficiency occurs when the atrial or ventricular muscle masses contract synchronously (see Eig. 1). The wave of excitation begins with the generation of electrical impulses within the SA node and spreads through the atria. The SA node is referred to as the pacemaker of the heart and exhibits automaticity, ie, it depolarizes and repolarizes spontaneously. The wave then excites sequentially the AV node the bundle of His, ie, the penetrating portion of the AV node the bundle branches, ie, the branching portions of the AV node the terminal Purkinje fibers and finally the ventricular myocardium. After the wave of excitation depolarizes these various stmetures of the heart, repolarization occurs so that each of the stmetures is ready for the next wave of excitation. Until repolarization occurs the stmetures are said to be refractory to excitation. During repolarization of the atria and ventricles, the muscles relax, allowing the chambers of the heart to fill with blood that is to be expelled with the next wave of excitation and resultant contraction. This process repeats itself 60—100 times or beats per minute... 

Glass lA Antiarrhythmic Agents. Class lA antiarrhythmic agents decrease automaticity, ie, depress pacemaker rates, especially ectopic foci rates produce moderate depression of phase 0 depolarization and thus slow conduction in atria, A-V node, His-Purkinje system, and ventricles prolong repolarization, ie, lengthen action potential duration increase refractoriness and depress excitabiHty. These electrophysiological effects are manifested in the ECG by increases in the PR, QRS, and QT intervals. 

The heart, a four-chambered muscular pump has as its primary purpose the propelling of blood throughout the cardiovascular system. The left ventricle is the principal pumping chamber and is therefore the largest of the four chambers in terms of muscle mass. The efficiency of the heart as a pump can be assessed by measuring cardiac output, left ventricular pressure, and the amount of work requHed to accomplish any requHed amount of pumping. 

The increased concentrations of K, Ca, Fe, Br, Se and Rb in infarction and scar areas are observed for patient with the recent infarction. For the patients with old infarction the levels of these elements are decreased in the same areas. This reflects the intensity of metabolic processes in the pathological area of myocardium. Additionally, the elevated levels of Se was find out in myocardium of right ventricle in both patients, that may be caused by the increasing the activity of the glutathione peroxidase enzyme. 

Herz-kammer, /. ventricle, -klappe, /. cardiac valve, -kurve, /. Math.) cardioid. -leiden, n. heart disease. 

Class IC antiarrhythmic drugs such as flecainide or propafenone block the Na+ channel (open state propafenone open and inactivated state) with a very long dissociation time constant so that they alter normal action potential propagation. Flecainide increased mortality of patients recovering from myocardial infarction due to its proarrhythmic effects (CAST study). Action potential is shortened in Purkinje fibres but is prolonged in the ventricles. 

The risk of atrial flutter is a 2 1 transmission to the ventricles generating a high ventricular rate. The therapeutic goal is to reduce transmission to 3 1 or 4 1 by administration of either (3-adrenoceptor antagonists, Ca2+ channel blockers or amiodarone. Quinidine must not be used in this arrhythmia, since it accelerates AV-conduction due to its vagolytic effect. 

I] (pyr1)apelin-13 used to characterise native apelin receptors in human heart (atria and ventricles) bound with a single high affinity ( AD = 0.4 nM),... 

The area postrema is a circumventricular brain region positioned on the dorsal surface of the medulla on the floor of the fourth ventricle. The blood-brain barrier and the cerebrospinal fluid-brain barrier are absent in this region and consequently many substances that do not pass across capillaries in other regions of the brain can do so in the area postrema. The chemoreceptor trigger zone (CTZ), located in the lateral area postrema is sensitive to blood-borne emetogens. Nerves from the CTZ connect with the vomiting centre. 

The regulation of the total peripheral resistance also involves the complex interactions of several mechanisms. These include baroreflexes and sympathetic nervous system activity response to neurohumoral substances and endothelial factors myogenic adjustments at the cellular level, some mediated by ion channels and events at the cellular membrane and intercellular events mediated by receptors and mechanisms for signal transduction. As examples of some of these mechanisms, there are two major neural reflex arcs (Fig. 1). Baroreflexes are derived from high-pressure barorecep-tors in the aortic arch and carotid sinus and low-pressure cardiopulmonary baroreceptors in ventricles and atria. These receptors respond to stretch (high pressure) or... 

CART (cocaine- and amphetamine-regulated transcript) is a hypothalamic peptide that inhibits both normal and starvation-induced feeding when injected into cerebral ventricles of rats. CART is co-localized with the anorexigenic peptide a-melanocyte-stimulating hormone in neurons of the arcuate nucleus. Secretion of CART is stimulated by leptin and CART may be an endogenous inhibitor of food intake. 

The lateral hypothalamic area has been identified as a feeding centre by studies involving electric stimulation and discrete lesions. Neurons in the lateral hypothalamic area and the neighbouring perifornical area express neuropeptides that stimulate feeding when injected into cerebral ventricles (orexins 1 and 2, melanin-concentrating hormone (MCH)). 

The locus ceruleus is a structure located on the floor of the fourth ventricle in the rostral pons. It contains more than 50% of all noradrenergic neurons in the brain, and projects to almost all areas of the central nervous system. 

The paraventricular nucleus in the hypothalamus is located adjacent to the third ventricle and has been identified as a satiety center. Neurons in the paraventricular nucleus produce neuropeptides which inhibit feeding when injected into the brain (thyrotropinreleasing hormone (TRH), corticotropin-releasing hormone (CRH), oxytocin). 

T-tubule is a transverse invagination of the plasma membrane, which occurs at the specified sites characteristic to animal species and organs, i.e. at the Z-line in cardiac ventricle muscle and non-mammalian vertebrate skeletal muscle and at the A-I junction in mammalian skeletal muscle. It is absent in all avian cardiac cells, all cardiac conduction cells, many mammalian atrial cells and most smooth muscle cells. T-tubule serves as an inward conduit for the action potential. 

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