The left atrium and the right ventricle: two supporting chambers to the failing left ventricle

2019 ◽  
Vol 24 (5) ◽  
pp. 661-669 ◽  
Author(s):  
Matteo Cameli ◽  
Maria Concetta Pastore ◽  
Michael Y. Henein ◽  
Sergio Mondillo
1976 ◽  
Vol 231 (3) ◽  
pp. 781-785 ◽  
Author(s):  
OM Brown

The distribution of acetylcholine (ACh) in the cat heart was investigated by a pyrolysis-gas chromatography (PGC) method. The hearts were dissected into various regions and homogenized in acetonitrile in the presence of propionylcholine, internal standard. Following extraction with toluene and hexane, the choline esters were precipitated as the enneaiodide complex. The isolated choline esters were analyzed by PGC, and the peak corresponding to ACh was quantified. The compound extracted from heart tissue that eluted with the retention time of authentic ACh was identified by mass spectrometry as dimethylaminoethylacetate, the pyrolysis product of ACh. ACh concentrations were found to be higher in the atria than the ventricles. In both the atria and the ventricles, a higher content of ACh was found in the right than the left portions: right ventricle, 5.0 compared to left ventricle, 2.0 nmol/g; and right atrium, 16.8 compared to left atrium, 11.3 nmol/g. Some cats were subjected to a bilateral cervical vagotomy 3 wk before removal and analysis of heart tissue. Hearts from vagotomized cats contained less ACh than controls in the right ventricle (-31%), right atrium (-54%), SA node (-42%), and papillary muscle (-53%), but no decreases were found in the left ventricle, left atrium, or interventricular septum.


2017 ◽  
Vol 7 (4) ◽  
pp. 240-247
Author(s):  
O. V. Filatova ◽  
E. Ivanova ◽  
V. Chursina

We conducted a retrospective study of EchoCG from 33 males who had the myocardial infarction. Patients with a diagnosis of "neurocirculatory dystonia" (30 people) entered the control group. We studied the size of the left ventricle, the left atrium, the right ventricle, their relationship to each other, the mass of the myocardium and the mass index of the myocardium of the left ventricle. The study of the morphological structures of the heart revealed a change in the size of the left ventricle, the left atrium and the right ventricle in patients who had an acute myocardial infarction, manifested by an increase in the end-diastolic and end-systolic dimensions of the left ventricle, the left atrium, and the right ventricle. In 2/3 of the patients who had an acute myocardial infarction, the normal geometry of the left ventricle was observed. Around one-quarter of the patients had a concentric remodeling (24%), an eccentric hypertrophy of the left ventricle was the least common (15%). The heart of patients who had an acute myocardial infarction demonstrates a lower functionality being compared to the subjects in the control group. In these groups, the maximum value of the DAC / DDR ratio is observed, the ejection fraction is reduced. To a greater extent, the onset of acute myocardial infarction was determined by the size and mass of the left ventricular myocardium. Important meaning had also the body weight, BMI, surface area of the body, the size of the left atrium, and the right ventricle.


1991 ◽  
Vol 1 (2) ◽  
pp. 155-157 ◽  
Author(s):  
James P. Gnanapragasam ◽  
Allan B. Houston ◽  
Robert H. Anderson

SummaryWe describe an unusual heart in which double outlet from the left atrium resulted in atrioventricular connections to a dominant left ventricle and to a left-sided rudimentary right ventricle, while the right atrium also connected to the left ventricle. This produced, in effect, double inlet left ventricle in association with discordant atrioventricular connections. The diagnosis was made by echocardiography and confirmed at post mortem examination.


2021 ◽  
Vol 37 ◽  
pp. 00061
Author(s):  
Vyacheslav Tarasevich

The article describes the features of venous blood outflow from the heart in the Baikal seal. The objects for the study were corrosion preparations of 11 hearts of the Baikal seal aged from 1 month to 10 years. In our research we used the methods of preparation, filling of vessels with the use of "Kudo" mounting foam, photographing and sketching the branching of vessels. It was established that in the Baikal seal, the outflow of venous blood occurs through the prominent coronary sinus and the large, intermediate, oblique vein of the left atrium, the middle and right heart veins that flow into it. In 18.2% of hearts, a coronary valve was found at the border of the great heart vein and the coronary sinus. The great heart vein begins above the apices of the heart and is formed from the fusing of the 6-11 collateral veins of the wall of the right ventricle, the venous pericardial plexus, and 9-16 branches on the side of the left ventricle. The most variable is the intermediate (marginal) branch, which in most cases has only one branch, however, in 18.2% of cases there are two ones or in 9.1% of cases, there are intermediate branches with a common trunk. The middle vein of the heart is located in the sub-sinus sulcus and anastomoses with the branch of the great vein of the heart, in 9.1% of cases, the valve of the coronary sinus was found at the border with the coronary sinus. The right veins of the heart have 5-6 branches, among which the marginal ones are the most prominent. 27.3% of Baikal seals have a venous sinus formed from the fusion of the middle and right coronary veins, as well as a duct connecting the large cardiac vein with this sinus.


1991 ◽  
Vol 261 (6) ◽  
pp. H1979-H1987 ◽  
Author(s):  
M. Gopalakrishnan ◽  
D. J. Triggle ◽  
A. Rutledge ◽  
Y. W. Kwon ◽  
J. A. Bauer ◽  
...  

To examine the status of ATP-sensitive K+ (K+ATP) channels and 1,4-dihydropyridine-sensitive Ca2+ (Ca2+DHP) channels during experimental cardiac failure, we have measured the radioligand binding properties of [3H]glyburide and [3H]PN 200 110, respectively, in tissue homogenates from the rat cardiac left ventricle, right ventricle, and brain 4 wk after myocardial infarction induced by left coronary artery ligation. The maximal values (Bmax) for [3H]glyburide and [3H]PN 200 110 binding were reduced by 39 and 40%, respectively, in the left ventricle, and these reductions showed a good correlation with the right ventricle-to-body weight ratio in heart-failure rats. The ligand binding affinities were not altered. In the hypertrophied right ventricle, Bmax values for both the ligands were not significantly different when data were normalized to DNA content or right ventricle weights but showed an apparent reduction when normalized to unit protein or tissue weight. Moderate reductions in channel densities were observed also in whole brain homogenates from heart failure rats. Assessment of muscarinic receptors, beta-adrenoceptors and alpha 1-adrenoceptors by [3H]quinuclidinyl benzilate, [3H]dihydroalprenolol, and [3H]prazosin showed reductions in left ventricular muscarinic and beta-adrenoceptor densities but not in alpha 1-adrenoceptor densities, consistent with earlier observations. It is suggested that these changes may in part contribute to the pathology of cardiac failure.


1987 ◽  
Vol 253 (6) ◽  
pp. H1381-H1390 ◽  
Author(s):  
W. L. Maughan ◽  
K. Sunagawa ◽  
K. Sagawa

To analyze the interaction between the right and left ventricle, we developed a model that consists of three functional elastic compartments (left ventricular free wall, septal, and right ventricular free wall compartments). Using 10 isolated blood-perfused canine hearts, we determined the end-systolic volume elastance of each of these three compartments. The functional septum was by far stiffer for either direction [47.2 +/- 7.2 (SE) mmHg/ml when pushed from left ventricle and 44.6 +/- 6.8 when pushed from right ventricle] than ventricular free walls [6.8 +/- 0.9 mmHg/ml for left ventricle and 2.9 +/- 0.2 for right ventricle]. The model prediction that right-to-left ventricular interaction (GRL) would be about twice as large as left-to-right interaction (GLR) was tested by direct measurement of changes in isovolumic peak pressure in one ventricle while the systolic pressure of the contralateral ventricle was varied. GRL thus measured was about twice GLR (0.146 +/- 0.003 vs. 0.08 +/- 0.001). In a separate protocol the end-systolic pressure-volume relationship (ESPVR) of each ventricle was measured while the contralateral ventricle was alternatively empty and while systolic pressure was maintained at a fixed value. The cross-talk gain was derived by dividing the amount of upward shift of the ESPVR by the systolic pressure difference in the other ventricle. Again GRL measured about twice GLR (0.126 +/- 0.002 vs. 0.065 +/- 0.008). There was no statistical difference between the gains determined by each of the three methods (predicted from the compartment elastances, measured directly, or calculated from shifts in the ESPVR). We conclude that systolic cross-talk gain was twice as large from right to left as from left to right and that the three-compartment volume elastance model is a powerful concept in interpreting ventricular cross talk.


2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
O Germanova ◽  
O Tereshina

Abstract Funding Acknowledgements Type of funding sources: None. Background. New COVID-19 disease is well known by its primary damage of respiratory system. However, it is also possible to involve other organs and systems. Purpose. To determine the cardiac involvement in patients with COVID-19 pneumonia. Materials and methods. We performed echocardiography with speckle tracking in 48 patients. All of them had serologically verified COVID-19 pneumonia with lung involvement 5-60% on CT. None of them were treated by antimalarial drugs. 28 of them were men and 20 women, mean age - 45 ± 4,4 years old. We performed echocardiography in 1 month period from onset of the disease. Results. Most of the patients (30 patients) had enlargement of right heart chambers. Despite of right ventricle enlargement, in none of the patients had reduced right ventricle function (TAPSE 22 ± 2 mm, right ventricle strain -21,2 ± 1,5%). The mean systolic pulmonary artery pressure was slightly elevated (38 ± 2 mm Hg). Left ventricle was enlarged in 9 patients (with mean end diastolic volume 82 ± 5 ml/m2). In 25 of them, the ejection fraction was decreased (44 ± 4%). In all patients with COVID-19 pneumonia, the changes in circumferential and longitudinal strain were observed. Both parameters were decreased. The mean value of circumferential strain was -16,3 ± 1,9%. The longitudinal strain parameter was -14,2 ± 1,4%. 25 patients had enlargement of left atrium (>40ml/m2) and the reservoir strain of left atrium was decreased (-23,3 ± 1,5%)  in 29 of them. After 2 months from the onset of the disease, we noticed the normalization of echocardiography data in all patients. Nevertheless, we observed cardiac structural and functional changes in all patients, troponins levels were increased only in 12 patients. Conclusion. We observed cardiac involvement in different degree in all of patients with COVID-19 pneumonia. Changes characterized by atriums and ventricles enlargement, and left ventricle contractile dysfunction.  Due to the fact that only part of the patients with COVID-19 with cardiac changes had elevated troponins, we believe that the mechanism of these pathological changes need further research.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Sacher ◽  
P Roumegou ◽  
J Duchateau ◽  
N Derval ◽  
A Denis ◽  
...  

Abstract Background Embolic event is one of the complications of VT ablation. This may be due to the presence of intra-cardiac thrombus before ablation. However, there is no clear consensus on how to rule out thrombus before the procedure. Objective We sought to examine the prevalence and risk factors of intra-cardiac thrombus with cardiac computed tomographic (CT) scan in patients undergoing scar-related VT ablation. Methods In absence of contra-indication, all patients undergoing scar-related VT ablation at our institution underwent contrast-enhanced cardiac CT within one week before ablation. 324 consecutive patients (292 male, 59±16 yo) have been included in this study. The etiology was ischemic cardiomyopathy (CMP) (n=191), arrhythmogenic right ventricular CMP (ARVC) (n=37), congenital CMP (n=11) or other CMP (n=85). LVEF was <40% in 154 patients (48%). Results Intra-cardiac thrombus was diagnosed in 29 (9%) patients: in the left atrium (n=8), in the right atrium (n=1), in the left ventricle (n=15), in the right ventricle (n=3), in right and left atrium (n=1), and in left atrium and right ventricle (n=1). Moreover in 2, a bilateral pulmonary embolism was identified. The population with thrombus was older (65±12 vs 58±16 years, p=0,005), with more permanent atrial fibrillation (AF) (28% vs 8%; p=0.005). Patients with left ventricular (LV) aneurysm were at higher risk of thrombus 50% vs 3% (p<0.001). The average CHADSVASC score was similar for both groups (2,5 vs 2,1; p=0.179). After matching for age and sex, only ischemic CMP and LV aneurysm were risk factors for thrombus. Because of arrhythmic storm, ablation was performed by epicardial approach only, in 5 patients with intra-ventricular thrombus and by retroaortic approach only, in 2 patients with LAA thrombus. No embolic event occurred during these procedures. Conclusion CT scans help eliminating intra-cardiac thrombus before VT ablation procedure. A high proportion of thrombus (9%) was identified. Whereas LV thrombus should systematically be ruled out before scar related VT ablation, in patients with AF, a LAA thrombus should also be eliminated as well as RV thrombus in patients with ARVC. Acknowledgement/Funding ANR-10-IAHU-04


2019 ◽  
Vol 11 (1) ◽  
pp. 123-126
Author(s):  
Sruti Rao ◽  
Robert D. Stewart ◽  
Gosta Pettersson ◽  
Carmela Tan ◽  
Suzanne Golz ◽  
...  

Enlargement of the bulboventricular foramen (BVF) in double-inlet left ventricle or the ventricular septal defect (VSD) in tricuspid atresia with transposition of the great arteries is one approach for prevention or treatment of systemic ventricular outflow obstruction. Most often, BVF/VSD restriction is bypassed preemptively or addressed directly at the time of Glenn/Fontan procedures as part of staged univentricular palliation. We describe a patient who underwent enlargement of a restrictive VSD during Fontan completion and subsequently presented with an asymptomatic pseudoaneurysm of the right ventricle at the ventriculotomy site.


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