Ventricular pressure

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. 

FIGURE 9.21 Changes in heart rate (ordinates) for agonist-induced changes in cardiac inotropy (changes in rate of ventricular pressure) in anesthetized cats. Responses shown to isoproterenol (filled circles) and dobutamine (open circles), (a) Response in normal cats shows inotropic selectivity (less tachycardia for given changes in inotropy) for dobutamine over isoproterenol, (b) The inotropic selectivity of dobutamine is reduced by previous a-adrenoceptor blockade by phentolamine. From [61],... 

The same applies to pathologically-disturbed function. A simulated reduction in coronary blood flow (heart attack) would lead to reduced oxygen supply to the cells in the virtual heart, which would reduce efficiency of cardiac contraction and possibly give rise to heart rhythm disturbances. Ventricular pressure development would be compromised, as would the blood supply to all organs of the body, including the heart. All these implications can be studied in a virtual heart. 

The individual modules of the in situ heart can be coupled together to compute a whole sequence from ventricular pressure development, coronary perfusion, tissue supply of metabolites, cell energy consumption, and electrophysiology, to contractile activity and ventricular pressure development in the subsequent beat. The starting point (here chosen as ventricular pressure development) can be freely selected, and drug effects on the system can be simulated. Inserted into a virtual torso, these models allow one to compute the spread of excitation, its cellular basis, and the consequences for an ECG under normal and pathological conditions. 

Ongoing work is devoted to the accurate description of the origin and spread of excitation from the natural pacemaker to the rest of the heart. Computations of ventricular pressure development are being extended to account for blood flow dynamics in adjacent blood vessels. The thorax... 

Anaesthetized studies conducted using data capture systems to record six lead ECG (I, II, III, aV, and aVf), left ventricular pressure variables, arterial blood pressure and respiratory measurement of arterial blood flow in selected vascular beds, cardiac output and arterial blood gas measurement. ECG intervals are measured from the lead II ECG and Q-T interval can be corrected for heart rate using Bazett s, Friderecia s or Van De Water s formulas. 

Sato, K., Kandori, H., and Sato, S., Evaluation of a new method using telemetry for monitoring the left ventricular pressure in free-moving rats, ]. Pharmacol. Toxicol. Methods, 31, 191-198,1994. 

During ventricular pressure experiments the heart rate was kept constant by pacing. Even with the heart rate constant, both DKPs displayed a decrease in coronary flow. Cyclo(Cys-Ile) was found to decrease coronary... 

Several studies have indicated that n-butane sensitizes the myocardium to epinephrine-induced cardiac arrhythmias. In anesthetized dogs, 5000 ppm caused hemodynamic changes such as decreases in cardiac output, left ventricular pressure, and stroke volume, myocardial contractility, and aortic pressure. Exposure of dogs to 1-20% butane for periods of 2 minutes to 2 hours hypersen-... 

According to Laplace s law, a reduction in ventricular pressure and heart size results in a decrease in the myocardial wall tension that is required to develop a given intraventricular pressure and therefore decreases oxygen requirement. Since blood flow to the subendocardium occurs primarily in diastole, the reduction in left ventricular end diastolic pressure induced by nitroglycerin reduces extravascular compression around the subendocardial vessels and favors redistribution of... 

Fig. 11. Changes In gated NMR spectra during the cardiac cycle. Top panel isovolumic left ventricular pressure In a ferret heart paced at 0.99 Hz in 8 mM [Ca +]. NMR spectra were acquired at the two times indicated on the pressure record (a) 10 ms prior to stimulation (b) 75 ms after stimulation. Middle panel shows gated F NMR spectra (each from 800 acquisitions) recorded at (a) and (b), as indicated. The bound (B) and free (F) peaks of 5F-BAPTA exhibit distinct chemical shifts at approximately 8 and 2 ppm, respectively, downfield from a standard of 1 mM 6-Ftryptophan at 0 ppm. It appears that the free [Ca +] varied during the cardiac cycle. Bottom panel shows gated P spectra (400 scans) acquired at times a and b in the same heart. The major peaks correspond to phosphocreatine (0 ppm), ATP (the three peaks upfield from phosphocreatine), and inorganic phosphate (the small peak at 4-5 ppm) (Reproduced from Marban et al. Circ. Res. 1988 63 673-678 [311] with permission of Lippincott, Williams Wilkins).

It is relatively selective inhibitor of peak III cyclic AMP phosphodiesterase isoenzyme in cardiac and vascular muscle. In patients with CHF, it produces dose related and plasma concentration related increase in the maximum rate of increase of left ventricular pressure. Milrinone has a direct inotropic and direct arterial vasodilator activity. It is administrated by IV infusion 0.50 mg/kg over 10 min with a maximum daily dose of 1.13 mg/kg. 

Left ventricular pressure measurements are monitored continuously by use of a 5F end-hole pig-tail catheter in the left ventricular apex and a 6F femoral sheath in order to be able to assess the gradient, If the outflow gradient is absent or small under the basal conditions, the magnitude of provocable obstruction is most appropriately assessed with maneuvers (Valsalva, ventricular pacing, extrasystoles, physiological exercise, amyl nitrate), The inability to elicit any provocable gradient is a contraindication to the procedure,... 

Ideally biomarkers of activity should be identified at various times over the course of the study to support the pharmacodynamic activity (e.g., normalization of insulin, improvement in beta cell function as measured by C-peptide level, or control of glucose following transplantation of P pancreatic islet cells) improvement of motor coordination in mice with spinal cord damage following transplant of neurons or repair of heart function (e.g., functional measures such as LV ejection fraction, pressure volume loops, ventricular pressure and heart wall thickness). Such markers may also be useful in subsequent clinical... 

The left ventricular pressure transducer is then implanted. The pericardium is opened so that the apex of the heart is exposed. The heart is gently held in one hand and two stitches in the ventricular wall for fixation are made. A purse-string suture is made around the apex. A sharp spike is then placed into the apex of the left ventricle and the transducer is placed into the ventricle and sutured firmly in place. 

The hemodynamic and ECG parameters include systolic, diastolic and mean aortic pressure, peak systolic and end-diastolic left ventricular pressure, LV dP/dt max and dP/dt min, heart rate PQ-, QRS- and QT intervals. NOTOCORD-software (or equivalent) is used for acquisition of data whereas EXCEL (or equivalent) is used for data analysis. Data are summarized at predefined time points by calculating median values+ SD. Whereas all physiological parameters are routinely averaged over predefined time intervals, it has been proposed that for the ECG only a few beats... 

---