Abnormal pulmonary flow is associated with impaired right ventricular coupling in patients with COPD

2021 ◽  
Author(s):  
Ani Oganesyan ◽  
Alexander Hoffner-Heinike ◽  
Alex J. Barker ◽  
Benjamin S. Frank ◽  
D. Dunbar Ivy ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Pulmonary Flow

Prostaglandins and fetal cardiac output distribution in the lamb

1985 ◽  
Vol 248 (6) ◽  
pp. H853-H858
Author(s):  
E. B. Sideris ◽  
K. Yokochi ◽  
F. Coceani ◽  
P. M. Olley
Keyword(s):  
Cardiac Output ◽  
Right Ventricular ◽  
Main Pulmonary Artery ◽  
Left Ventricular ◽  
Base Line ◽  
Pulmonary Flow ◽  
Pulmonary Vasodilator ◽  
Distribution Right ◽  
Output Ratio ◽  
Left Ventricular Output

With the use of a triple thermodilution technique in 17 fetal lambs, combined with microsphere estimations in 7, the effects of indomethacin prostaglandin (PG) I2 and PGE2 on cardiac output and its distribution were measured. Indomethacin (0.2 mg/kg) induced a main pulmonary artery-to-aorta pressure gradient, which peaked within 45–60 min and persisted for 2–3 h. PGE2 abolished this gradient (threshold 50 ng X kg-1 X min-1), while PGI2 in doses up to 100 ng X kg-1 X min-1 increased it. Indomethacin did not change total cardiac output but altered its distribution (right ventricular output, left ventricular output) and increased the percentage of right ventricular output flowing to the lungs. Ductal flow decreased concomitantly. After indomethacin, PGI2 further decreased ductal flow, increased pulmonary flow, and decreased pulmonary vascular resistance. PGE2 restored the original right ventricular-to-total cardiac output ratio, although ductus flow did not return to base-line levels. Pulmonary resistance increased slightly, reflecting decreased pulmonary flow, associated with decreased right ventricular output. Thus PGE2 was more effective on the ductus than on the pulmonary circulation. PGI2 did not relax the ductus but was a potent pulmonary vasodilator. Neither PGI2 nor PGE2 nor indomethacin changed total cardiac output but all altered its distribution.

In Vitro Hemocompatibility Evaluation of Modified Rotary Left to Right Ventricular Assist Devices in Pulmonary Flow Conditions

ASAIO Journal ◽  
2019 ◽  
Vol 66 (6) ◽  
pp. 637-644
Author(s):  
Chris Hoi Houng Chan ◽  
Deepika Nandakumar ◽  
Nicoletta Balletti ◽  
Jarod Horobin ◽  
Eric Lee-Jan Wu ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Assist Devices ◽  
Flow Conditions ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Pulmonary Flow

Measurement of right ventricular volume by conductance catheter in closed-chest pigs

1995 ◽  
Vol 269 (3) ◽  
pp. H869-H876 ◽  
Author(s):  
T. M. Stamato ◽  
R. S. Szwarc ◽  
L. N. Benson
Keyword(s):  
Right Ventricular ◽  
Cardiac Cycle ◽  
Ventricular Volume ◽  
Gain Factor ◽  
Conductance Catheter ◽  
Closed Chest ◽  
Inferior Caval Vein ◽  
Pulmonary Flow ◽  
Volume Relation ◽  
Parallel Conductance

This study details the effects of changes in right ventricular (RV) volume on the conductance catheter gain factor both over a broad volume range and within the cardiac cycle. In seven closed-chest anesthetized pigs, a conductance catheter was introduced transvenously and positioned to span the RV long axis, including the outflow tract. Parallel conductance was determined using a saline dilution technique. Conductance volume gain factor (alpha) was computed using stroke volume obtained by thermodilution over a range of volumes obtained by volume loading or sustained partial occlusion of the inferior caval vein. The chest was then opened, an ultrasonic flow probe was placed around the pulmonary artery, and the conductance-derived RV volume was compared with the pulmonary flow integral over the course of ejection. When volume was varied over a broad range, an inverse relation between RV volume and alpha was observed (P < 0.001). This did not cause significant nonlinearity of the conductance-volume relation. The relation was also relatively linear during the course of ejection within the cardiac cycle. These results indicate that the conductance catheter may be employed, using the described technique, to assess RV volume under steady-state conditions.

Preload-adjusted right ventricular maximal power: concept and validation

2004 ◽  
Vol 287 (4) ◽  
pp. H1632-H1640 ◽  
Author(s):  
Soren Schenk ◽  
Zoran B. Popović ◽  
Yoshie Ochiai ◽  
Fernando Casas ◽  
Patrick M. McCarthy ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Stroke Work ◽  
Maximal Power ◽  
End Diastolic Volume ◽  
Pulmonary Flow ◽  
The Difference ◽  
The Relationship ◽  
Preload Dependency

Right ventricular (RV) maximal power (PWRmx) is dependent on preload. The objective of this study was to test our hypothesis that the PWRmx versus end-diastolic volume (EDV) relationship, analogous to the load-independent stroke work (SW) versus EDV relationship (preload-recruitable SW, PRSW), is linear, with the PWR x-axis intercept (V0PWR) corresponding to the PRSW intercept (V0SW). If our hypothesis is correct, the preload sensitivity of PWRmx could be eliminated by adjusting for EDV and V0PWR. Ten dogs were instrumented with a pulmonary flow probe, micromanometers, and RV conductance catheter. Data were obtained during bicaval occlusions under various conditions and fitted to PWRmx = a·(EDV − V0PWR)β, where a is the slope of the relationship. The PWRmx versus EDV relationship did not deviate from linearity (β = 1.09, P = not significant vs. 1), and V0PWR correlated with V0SW ( r = 0.93, P <0.0001). V0PRW was related to steady-state EDV and left ventricular end-diastolic pressure, allowing for estimation of V0PWR (V0Est) and single-beat PWRmx preload adjustment. Dividing PWRmx by the difference of EDV and V0PWR (PAMPV0PWR) eliminated preload dependency down to 50% of the baseline EDV. PWRmx adjustment using V0Est (PAMPV0Est) showed similar preload independency. Enhancing contractility increased PAMPV0PWR and PAMPV0Est from 176 ± 52 to 394 ± 205 W/ml × 104 and 145 ± 51 to 404 ± 261 W/ml × 104, respectively, accompanied by an increase of PRSW from 13.0 ± 4.5 to 29.7 ± 16.4 mmHg (all P <0.01). PAMPV0PWR and PAMPV0Est correlated with PRSW ( r = 0.85; r = 0.77; both P <0.001). Numerical modeling confirmed the accuracy of our experimental data. Thus preload adjustment of PWRmx should consider a linear PWRmx versus EDV relationship with distinct V0PWR. PAMPV0PWR is a preload-independent estimate of RV contractility that may eventually be determined noninvasively.

scholarly journals Use of a right ventricular continuous flow pump to validate the distensible model of the pulmonary vasculature

2019 ◽  
pp. 233-243
Author(s):  
F. Vanden Eynden ◽  
P. Segers ◽  
T. Bové ◽  
F. De Somer ◽  
B. El Oumeiri ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Surface Area ◽  
Continuous Flow ◽  
Pulmonary Arteries ◽  
Pulmonary Vasculature ◽  
Flow State ◽  
Mean Flow ◽  
Mean Pulmonary Arterial Pressure ◽  
Pulmonary Flow

In the pulmonary circulation, resistive and compliant properties overlap in the same vessels. Resistance varies nonlinearly with pressure and flow; this relationship is driven by the elastic properties of the vessels. Linehanet al. correlated the mean pulmonary arterial pressure and mean flow with resistance using an original equation incorporating the distensibility of the pulmonary arteries. The goal of this study was to validate this equation in an in vivo porcine model. In vivo measurements were acquired in 6 pigs. The distensibility coefficient (DC) was measured by placing piezo-electric crystals around the pulmonary artery (PA). In addition to experiments under pulsatile conditions, a right ventricular (RV) bypass system was used to induce a continuous pulmonary flow state. The Linehanet al. equation was then used to predict the pressure from the flow under continuous flow conditions. The diameter-derived DC was 2.4%/mmHg (+/-0.4%), whereas the surface area-based DC was 4.1 %/mmHg (+/-0.1%). An increase in continuous flow was associated with a constant decrease in resistance, which correlated with the diameter-based DC (r=-0.8407, p=0.044) and the surface area-based DC (r=-0.8986, p=0.028). In contrast to the Linehanet al. equation, our results showed constant or even decreasing pressure as flow increased. Using a model of continuous pulmonary flow induced by an RV assist system, pulmonary pressure could not be predicted based on the flow using the Linehanet al. equation. Measurements of distensibility based on the diameter of the PA were inversely correlated with the resistance.

scholarly journals Additional Cross-sectional Transesophageal Echocardiography Views Improve Perioperative Right Heart Assessment

2012 ◽  
Vol 117 (4) ◽  
pp. 726-734 ◽  
Author(s):  
Jorge Kasper ◽  
Daniel Bolliger ◽  
Karl Skarvan ◽  
Peter Buser ◽  
Miodrag Filipovic ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Transesophageal Echocardiography ◽  
Pulmonary Valve ◽  
Right Heart Failure ◽  
Right Heart ◽  
Cross Sectional ◽  
Perioperative Morbidity ◽  
Pulmonary Flow ◽  
Right Ventricular Wall ◽  
The Right

Background Right heart failure is an important cause of perioperative morbidity and mortality, and transesophageal echocardiography (TEE) is crucial for its diagnosis. However, only four of the 20 cross-sectional views recommended in current guidelines for intraoperative TEE focus on the right heart. This study analyzed whether incorporating additional views into the standard TEE examination improves assessment of the right heart. Methods Sixty patients underwent standard TEE examination after induction of anesthesia. In addition, five views focusing on the right heart were acquired. Offline analysis tested: (1) whether the additional TEE views can be acquired as reliably as standard views including parts of the right heart; whether incorporating additional views improves the assessment of (2) eight or more right ventricular wall segments based on a predefined nine-segment model; (3) the tricuspid or pulmonary valve in two or more planes; and (4) transvalvular tricuspid and pulmonary flow in orthograde fashion. Results Additional views could be imaged as reliably (88%) as standard views (90%). Incorporating some of the additional views allowed the assessment of eight or more right ventricular segments in 59 (98%) versus 18 patients (30%) by the standard views alone, and of the pulmonary valve in two or more planes in 60 (100%) versus 15 patients (25%). Several additional views improved orthograde assessment of transvalvular pulmonary flow, but not of tricuspid flow. Conclusions The additional TEE views focusing on the right heart can be acquired as reliably as standard views. Incorporating three of them into the standard TEE examination improves comprehensive assessment of the right heart.

Studies on Ultrastructure and Cytochemistry of Right Ventricular Endomyocardial Biopsy

1990 ◽  
Vol 48 (3) ◽  
pp. 256-257
Author(s):  
Xia Mingyu ◽  
Ma Wengshu ◽  
Wu Xiangh ◽  
Chen Dong
Keyword(s):  
Light Microscopy ◽  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Endomyocardial Biopsy ◽  
Heart Diseases ◽  
Ultrastructural Localization ◽  
Controlled Study ◽  
Myocardial Biopsy ◽  
Morphological Assessment ◽  
Rheumatic Heart

This paper describes morphological and cytochemistry changes of endomyocardial biopsy in 94 patients. The samples of myoicardium were taken from 32 patients with dilated cardiomyopathy, and sdudied with light and electron microscop. The cytochemical studies in some of these patients were performed at histological and ultrastructure level. This paper also reported the result of myocardial biopsy in 33 patients with serious dysrythmia.The result of this controlled study indicates that morphological assessment in both cardiomyopathy and congenital or rheumatic heart diseases showed no special changes. In patients of dilated cardiomyopathy, the decreased activity of myosin ATPase was secondary to cardial failure. The change of succinate dehydrogenase (SDHase) was not significant with light microscopy. But ultrastructural localization of SDHase activity is valuable. Its activity was found to be localized in endomembrane and ridge of the mitochondria, the activity of this enzyme was decrease, normal, or increase. SDHase activity was more intense in cardial myocytes well-functioning, or ultrastructurally well preserved hearts.

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