Effect of reduced total blood volume on left ventricular volumes and kinetics in type 2 diabetes

To examine the mechanism by which atrial natriuretic peptide (ANP) decreases cardiac output, we studied changes in the heart, peripheral circulation, and blood flow distribution in eight dogs. ANP was given as a bolus (3.0 micrograms/kg) followed by an infusion of 0.3 microgram.kg-1.min-1. ANP did not change heart rate, total peripheral vascular resistance, and the first derivative of left ventricular pressure but decreased mean aortic pressure from 91 +/- 4 to 76 +/- 3 mmHg (P less than 0.001) and cardiac output from 153 +/- 15 to 130 +/- 9 ml.kg-1.min-1 (P less than 0.02). Right atrial pressure and left ventricular end-diastolic pressure also decreased. Mean circulatory filling pressure decreased from 7.1 +/- 0.3 to 6.0 +/- 0.3 mmHg (P less than 0.001), but venous compliance and unstressed vascular volume did not change. Resistance to venous return increased from 0.056 +/- 0.008 to 0.063 +/- 0.010 mmHg.ml-1.kg.min (P less than 0.05). Arterial compliance increased from 0.060 +/- 0.003 to 0.072 +/- 0.004 ml.mmHg-1.kg-1 (P less than 0.02). Total blood volume and central blood volume decreased from 82.2 +/- 3.1 to 76.2 +/- 4.6 and from 19.8 +/- 0.8 to 17.6 +/- 0.6 ml/kg (P less than 0.02), respectively. Blood flow increased to the kidneys. We conclude that ANP decreases cardiac output by decreasing total blood volume. This results in a lower operating pressure and volume in the venous capacitance system with no significant venodilating effects. Cardiac factors and a redistribution of flow to the splanchnic organs are not important mechanisms to explain the decrease in cardiac output with ANP.

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Left ventricular function and the distribution of pulmonary and total blood volume in hypertensive and normotensive man

Nuclear Medicine Communications ◽

10.1097/00006231-198410000-00002 ◽

1984 ◽

Vol 5 (10) ◽

pp. 609-618 ◽

Cited By ~ 1

Author(s):

IAN MACKAY ◽

KARL NATH ◽

MICHAEL L. WATSON ◽

WILLIAM J. HANNAN ◽

ALEXANDER L. MUIR

Keyword(s):

Left Ventricular Function ◽

Ventricular Function ◽

Blood Volume ◽

Left Ventricular ◽

Total Blood Volume ◽

Total Blood

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Exercise heat acclimation has minimal effects on left ventricular volumes, function and systemic hemodynamics in euhydrated and dehydrated trained humans

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00466.2020 ◽

2020 ◽

Vol 319 (5) ◽

pp. H965-H979

Author(s):

Gavin Travers ◽

José González-Alonso ◽

Nathan Riding ◽

David Nichols ◽

Anthony Shaw ◽

...

Keyword(s):

Heart Rate ◽

Cardiac Output ◽

Left Ventricle ◽

Blood Volume ◽

Heat Acclimation ◽

Left Ventricular ◽

Systemic Hemodynamics ◽

Diastolic Filling ◽

Left Ventricular Volumes ◽

Ventricular Volumes

This study demonstrates that 10 days of exercise heat acclimation has minimal effects on left ventricular volumes, intrinsic cardiac function, and systemic hemodynamics during prolonged, repeated semirecumbent exercise in moderate heat, where heart rate and blood volume are similar to preacclimation levels. However, progressive dehydration is consistently associated with similar degrees of hyperthermia and tachycardia and reductions in blood volume, diastolic filling of the left ventricle, stroke volume, and cardiac output, regardless of acclimation state.

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Observations on Cardiac Output and ”Pulmonary Blood Volume” in Normal Man by External Recording of the Intracardiac Flow of 131I Labelled Albumin

Nuklearmedizin ◽

10.1055/s-0037-1621159 ◽

1961 ◽

Vol 1 (04) ◽

pp. 353-379

Author(s):

Jacques Lammerant ◽

Norman Veall ◽

Michel De Visscher

Keyword(s):

Cardiac Output ◽

Blood Volume ◽

Normal Subjects ◽

Published Data ◽

Total Blood Volume ◽

Total Blood ◽

Pulmonary Blood Volume ◽

Intracardiac Flow ◽

Normal Man ◽

Mean Circulation

Summary1. The technique for the measurement of cardiac output by external recording of the intracardiac flow of 131I labelled human serum albumin has been extended to provide a measure of the mean circulation time from right to left heart and hence a new approach to the estimation of the pulmonary blood volume.2. Values for the basal cardiac output in normal subjects and its variations with age are in good agreement with the previously published data of other workers.3. The pulmonary blood volume in normal man in the basal state was found to be 28.2 ± 0.6% of the total blood volume.4. There was no correlation between cardiac output and pulmonary blood volume in a series of normal subjects in the basal state.5. The increase in cardiac output during digestion was associated with a decrease in pulmonary blood volume equal to 6.3 ± 1.2% of the total blood volume, that is, about 280 ml.6. The increase in cardiac output during exercise was associated with a decrease in pulmonary blood volume equal to 4.5 ± 1.0% of the total blood volume, that is, about 200 ml.7. The increase in cardiac output attributed to alarm is not associated with a decrease in pulmonary blood volume, the latter may in fact be increased.8. The total blood volume is advocated as a standard of reference for studies of this type in normal subjects in preference to body weight or surface area.9. The significance of these results and the validity of the method are discussed.

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160-OR: Acute Changes in Plasma Glucose Have Impact on Left Ventricular Systolic Function in Insulin-Treated Patients with Type 2 Diabetes

Diabetes ◽

10.2337/db20-160-or ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 160-OR

Author(s):

ANDREAS ANDERSEN ◽

PETER G. JØRGENSEN ◽

JONATAN I. BAGGER ◽

MARIA POMPEA ANTONIA BALDASSARRE ◽

MIKKEL B. CHRISTENSEN ◽

...

Keyword(s):

Type 2 Diabetes ◽

Plasma Glucose ◽

Systolic Function ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Ventricular Systolic Function ◽

Acute Changes

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Association of SGLT2 inhibitors with outcomes in Type 2 diabetes with reduced and preserved left ventricular ejection fraction — Analysis from the CVD‐REAL 2 Study

Diabetes Obesity and Metabolism ◽

10.1111/dom.14356 ◽

2021 ◽

Author(s):

Carolyn S. P. Lam ◽

Avraham Karasik ◽

Cheli Melzer‐Cohen ◽

Matthew A. Cavender MD ◽

Shun Kohsaka ◽

...

Keyword(s):

Type 2 Diabetes ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Sglt2 Inhibitors ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction

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Effect of heart rate on left ventricular longitudinal myocardial function in type 2 diabetes mellitus

Cardiovascular Diabetology ◽

10.1186/s12933-021-01278-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Yuki Yamauchi ◽

Hidekazu Tanaka ◽

Shun Yokota ◽

Yasuhide Mochizuki ◽

Yuko Yoshigai ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Heart Rate ◽

Type 2 Diabetes Mellitus ◽

Myocardial Function ◽

Normal Subjects ◽

Left Ventricular ◽

High Heart Rate ◽

Lv Dysfunction

Abstract Background Left ventricular (LV) longitudinal myocardial dysfunction is considered a marker of preclinical LV dysfunction in patients with type 2 diabetes mellitus (T2DM). High heart rate (HR) is associated with cardiovascular outcomes, but the effect of HR on LV longitudinal myocardial function in T2DM patients is uncertain. Methods We studied 192 T2DM patients with preserved LV ejection fraction (LVEF), and 81 age-, sex-, and LVEF-matched healthy volunteers. HR was measured as the average HR during echocardiography, and high HR was defined as resting HR ≥ 70 beats/minute. LV longitudinal myocardial function was assessed as global longitudinal strain (GLS). The predefined cutoff for subclinical LV dysfunction was set at GLS < 18%. Results GLS in T2DM patients with high HR was significantly lower than that in T2DM patients with low HR (16.3% ± 4.2% vs. 17.8% ± 2.8%; P = 0.03), whereas GLS in normal subjects with high and low HR was similar (20.3 ± 1.7% vs. 20.3 ± 2.0%; P = 0.99). Multivariable logistic regression analysis showed that high HR (odds ratio: 1.04; 95% confidence interval: 1.01–1.07; P = 0.01) was independently associated with GLS < 18% in T2DM patients as well as HbA1c, T2DM duration, LVEF, body mass index, and mitral inflow E and mitral e’ annular velocity ratio. One sequential logistic model evaluating the associations between GLS < 18% and clinical variables in T2DM patients showed an improvement with the addition of LVEF and E/e’ (P < 0.001) and a further improvement with the addition of high HR (P < 0.001). Conclusion Compared with normal subjects, resting HR was associated with LV longitudinal myocardial function in asymptomatic T2DM patients with preserved LVEF. Our findings provide new insights on the management of T2DM patients.

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