Dynamics of blood flow in the ductus arteriosus

1965 ◽  
Vol 208 (3) ◽  
pp. 471-476 ◽  
Author(s):  
John A. Morris ◽  
George A. Bekey ◽  
N. S. Assali ◽  
Russell Beck
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Ductus Arteriosus ◽  
Aortic Pressure ◽  
Analog Computer ◽  
Inertial Characteristic ◽  
Lung Expansion ◽  
Before And After ◽  
Flow Pressure ◽  
The Right

The instantaneous pulsatile flow-pressure relationships across the ductus arteriosus were studied in fetal lambs before and after progressive lung expansion. Analysis of the same flow-pressure relationship was simulated on an analog computer using a mathematical model of the fetal circulation. The results demonstrate that 1) the blood flow through the ductus has a distinctive inertial characteristic and 2) there exists an asynchrony between the ejection of the two ventricles; the ejection of the right ventricle precedes that of the left. Both these factors explain the paradox of flow across the ductus from pulmonary artery to aorta (right-to-left shunt) which is seen when the lungs are incompletely expanded and the aortic pressure is higher than the pulmonary artery pressure.

Atrial natriuretic peptide levels in adult patients before and after surgery for correction of atrial septal defects: relationship with atrial arrhythmias

2004 ◽  
Vol 107 (3) ◽  
pp. 297-302 ◽  
Author(s):  
Ali R. ERBAY ◽  
Mehmet B. YILMAZ ◽  
Mustafa BALCI ◽  
Irfan SABAH
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Right Atrial ◽  
Control Group ◽  
Atrial Arrhythmias ◽  
Short Axis ◽  
Corrective Surgery ◽  
Before And After ◽  
The Right ◽  
Atrial Area

In the present study, we have examined whether increased N-ANP (N-terminal pro-ANP) levels before and after surgery in patients with ASD (atrial septal defect) along with echocardiographic findings provide a better insight into the pathophysiology and increased morbidity and mortality following corrective surgery. Eighteen adult ASD patients (>20 years of age; six male and 12 female) with shunts (Qp/Qs≥2, where Qp/Qs is the pulmonary blood flow/systemic blood flow) had complete echocardiographic, clinical and laboratory parameters evaluated before and 6 months after surgery. Eight age- and sex-matched individuals (three male and five female) were enrolled as a control group. Blood samples for N-ANP analysis were obtained in both groups. N-ANP levels in the peripheral blood sample from ASD patients before surgery were significantly higher than those in the control group. In patients with ASD, mean N-ANP levels obtained from the pulmonary artery were significantly higher than that obtained from the peripheral vein. RA (right atrial) area, adjusted for body surface area, and RA long-axis and short-axis measurements were significantly higher in the patient group than the control group. N-ANP was correlated significantly with these parameters. Following corrective surgery, N-ANP values and RA area, RA long-axis and short-axis normalization decreased significantly and were accompanied by a decrease in systolic mean pulmonary artery pressure. N-ANP levels were normalized following septal closure in most patients, except in those with atrial fibrillation attacks following corrective surgery. In conclusion, we have shown correlations among variables indicating changes in the architecture of the right atrium along with temporal changes in ANP providing insights into the pathophysiology of post-operative atrial arrhythmias.

scholarly journals Evaluation of the morphology and mechanics of the right ventricle using echocardiography before and after transcatheter balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
KIRILL Malikov ◽  
MARINA Kirichkova ◽  
MARIA Simakova ◽  
NARECK Marukyan ◽  
OLGA Moiseeva
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Artery Pressure ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Reverse Remodeling ◽  
Free Wall ◽  
Artery Pressure ◽  
Balloon Pulmonary Angioplasty ◽  
Before And After ◽  
The Right

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Chronic thromboembolic pulmonary hypertension (CTEPH) leads to a progressive increase in pulmonary vascular resistance (PVR) and pulmonary artery pressure (PAP) with the development of severe dysfunction of the right heart and heart failure. Mortality for three years with an average pressure in the pulmonary artery (PA) of more than 50 mmHg is more than 90%. Balloon pulmonary angioplasty (BPA) has a significant advantage over other methods of surgical treatment, but it requires the determination of additional non-invasive markers of effectiveness. Transthoracic echocardiography (TTE) remains the main method for assessing the morphology and function of the heart. Purpose Compare different indicators reflecting the severity of CTEPH with TTE indicators before and after BPA. To evaluate the effectiveness of using BPA for the treatment of patients with CTEPH using routine TTE and speckle tracking mode. Materials and methods For 18 months 30 patients without concomitant cardiovascular pathology were subjected to several BPA sessions. Before treatment, 50% of patients belonged to the 3 CTEPH functional class (FC), 40% to 2 FC, 10% to 1 FC. The average number of sessions was 4.7 ± 1.3. Before the first BPA and after the last, all the patients were performed: six-minute walk test (6MWT, metres), Borg scale (in points), test for NT-proBNP (pg/ml); TTE with assessment of the right ventricle (RV) and left ventricle (LV) including areas of the right atrium (aRA, cm2), mean pulmonary artery pressure (PUPM,mmHg),RV free wall strain (GLSFW, %), RV free wall strain rate (GLSRFW, sm/sec), RV free wall postsystolic shortening (PSSFW, %), tricuspid annular plane systolic excursion (TAPSE, sm), tricuspid annulus systolic velocity (TASV, sm/sec). Results. Before the first BPA session, the 6MWT in the patient group averaged 315.9 ± 9.08 metres, after - 439.5 ± 11.45 m; the Borg from 5.4 ± 0.94 points decreased to 4 ± 1.01 points; NT-proBNP before the treatment was 1513 ± 13.01 pg/ml, after - 171 ± 6.09; according to TTE the ratio of RV/ LV before and after treatment was 1.31 ± 0.02 and 0.97 ± 0.04; aRA was 29.3 ± 4.87 and 22.3 ± 3.53 cm2; basal RV - 52 ± 5.11 and 44 ± 7.26 mm; PUPM decreased from 76.6 ± 7.65 to 31.3 ± 3.78 mmHg; GLSFW from -14.69 ± 2.33 came to 17.5 ± 3.45 %; GLSRFW with -0.9 ± 0.09 to -1.7 ± 0.11 cm/sec; TAPSE from 16.7 ± 1.87 to 18.2 ± 2.34 cm; TASV from 10.11 ± 1.45 to 12.25 ± 1.98 cm/s, PSSFW before treatment was -18.4 ± 1.2%, after treatment in 66% of patients disappeared, in 34% became an average of 17.4 ± 0.9% The distribution of STEPH FC has also changed. Conclusion. BPA leads to an improvement in the tolerance of physical activity, clinical indicators, and parameters of central hemodynamics in the pulmonary circulation, evaluated according to direct manometry, and leads to reverse remodeling of the RV in the long term. Performing a staged BPA leads to an improvement in the functional parameters of contractility of the RV.

Blood Flow Velocity Profiles in Pulmonary Branch Arteries in Lambs

1995 ◽  
Vol 117 (2) ◽  
pp. 237-241
Author(s):  
H. Katayama ◽  
G. W. Henry ◽  
C. L. Lucas ◽  
B. Ha ◽  
J. I. Ferreiro ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Maximum Velocity ◽  
Left Pulmonary Artery ◽  
Control Group ◽  
Pulsed Doppler Ultrasound ◽  
Right Pulmonary Artery ◽  
Blood Flow Velocities ◽  
The Right

We studied the detailed profiles of blood flow in the right and left pulmonary arteries using 20 MHz pulsed Doppler ultrasound equipment in a lamb model. Fourteen lambs aged four to six weeks were selected. In six lambs, monocrotaline pyrrole was injected parenterally to create pulmonary hypertension (PH group). Eight other lambs served as unaltered controls (control group). The blood flow velocities were sampled in 1mm increments along the anterior—posterior axis of the branch arteries. The maximum velocity of the forward flow in the left pulmonary artery was higher than that in the right pulmonary artery in the control group (71.7 ± 15.9cm/s vs 60.2 ± 13.5; p < 0.05). The fastest backward flow was located at the posterior position of the vessel in the right pulmonary artery in the control group. No significant bias in location was shown in the left pulmonary artery. Using indices of P90, acceleration time, P90*AcT, the velocity waveforms in the PH group were compared with those in the control group. In the left pulmonary artery, every index in the control group showed a significantly greater value that in the PH group. On the other hand, no significant differences were found between either group in the right pulmonary artery.

PROBLEM OF DIFFERENTIAL DIAGNOSIS IN INFANTS WITH LARGE HEARTS AND INCREASED BLOOD FLOW TO THE LUNGS

PEDIATRICS ◽  
1954 ◽  
Vol 13 (1) ◽  
pp. 30-40
Author(s):  
CHARLOTTE FERENCZ ◽  
ARNOLD L. JOHNSON ◽  
ALTON GOLDBLOOM
Keyword(s):  
Blood Flow ◽  
Differential Diagnosis ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Pulmonary Veins ◽  
Heart Catheterization ◽  
Radiologic Findings ◽  
The Right ◽  
Increased Blood Flow ◽  
Patent Ductus

This paper deals with the differential diagnosis of the cardiac lesion in infants who have enlargement of the heart associated with increased blood flow to the lungs, and in whom cyanosis is not a prominent feature. Some patients in this group have a patent ductus arteriosus in the absence of a typical continuous murmur, and these infants may urgently require the benefits of surgical therapy. Since the diagnosis can be established by aortography or heart catheterization, some criteria are required for the better selection of infants from this group in whom these investigations should be performed. Twenty-five infants form the subject of this study. In 19 the diagnosis was confirmed at autopsy. Eight patients had a patent ductus, either as an isolated lesion or in association with other defects; 10 had ventricular septal defects with or without overriding of the aorta; 5 had anomalous pulmonary vein drainage; one had an ostium atrioventricular communis and in one there was a functional single ventricle. Clinical, electrocardiographic and radiologic findings were analyzed. Important features which appear to favour the diagnosis of patent ductus arteriosus are full or collapsing pulses and a normal ECG or one showing evidence of combined ventricular hypertrophy. Suggestive, but of lesser importance, is the finding of an apical diastolic rumble and enlargement of the left atrium. All these findings may, however, be present in patients with other malformations, especially defects involving the ventricular septum. Evidence of marked hypertrophy of the right atrium and right ventricle by electrocardiography and fluoroscopy renders the presence of patent ductus unlikely and is consistent with the diagnosis of anomalous drainage of pulmonary veins.

In Reply: Cerebral Blood Flow

PEDIATRICS ◽  
1982 ◽  
Vol 70 (6) ◽  
pp. 1013-1014
Author(s):  
RAUL BEJAR
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gastrointestinal Tract ◽  
Ductus Arteriosus ◽  
Left Ventricular ◽  
Blood Flows ◽  
Before And After ◽  
Regional Blood Flows ◽  
Left Ventricular Output ◽  
Patent Ductus

Baylen and Emmanouilides give the impression that their abstract was misquoted in our commentary. We would like to explain our interpretation of their data. In the abstract, Baylen et al indicate that they measured regional blood flows (RBF) in premature fetal lambs, expressing them as a percentage of the left ventricular output (LVO) before and after patent ductus arteriosus (PDA) closure. Their results (percent of LVO) before and after PDA closure were: lung, 42.7% vs 8.4% (P &lt; .01); carcass, 35% vs 55% (P &lt; .01); heart, 5.5% vs 10.2% (P &lt; .05); gastrointestinal tract, 5.1% vs 9.3% (P &lt; .05); brain, 2.7% vs 3.4% (P = NS); kidney, 2.2% vs 3.3% (P = NS); liver, 3.2% vs 5.7% (P = NS).

scholarly journals Inhaled carbon monoxide does not cause pulmonary vasodilation in the late-gestation fetal lamb

2000 ◽  
Vol 278 (4) ◽  
pp. L779-L784 ◽  
Author(s):  
Theresa R. Grover ◽  
Robyn L. Rairigh ◽  
Jeanne P. Zenge ◽  
Steven H. Abman ◽  
John P. Kinsella
Keyword(s):  
Carbon Monoxide ◽  
Blood Flow ◽  
Pulmonary Artery ◽  
Vascular Tone ◽  
Ductus Arteriosus ◽  
Protoporphyrin Ix ◽  
Left Lung ◽  
Late Gestation ◽  
Zinc Protoporphyrin ◽  
Pulmonary Vasodilation

As observed with nitric oxide (NO), carbon monoxide (CO) binds and may activate soluble guanylate cyclase and increase cGMP levels in smooth muscle cells in vitro. Because inhaled NO (INO) causes potent and sustained pulmonary vasodilation, we hypothesized that inhaled CO (ICO) may have similar effects on the perinatal lung. To determine whether ICOcan lower pulmonary vascular resistance (PVR) during the perinatal period, we studied the effects of ICOon late-gestation fetal lambs. Catheters were placed in the main pulmonary artery, left pulmonary artery (LPA), aorta, and left atrium to measure pressure. An ultrasonic flow transducer was placed on the LPA to measure blood flow to the left lung. After baseline measurements, fetal lambs were mechanically ventilated with a hypoxic gas mixture (inspired O2fraction < 0.10) to maintain a constant fetal arterial [Formula: see text]. After 60 min (baseline), the lambs were treated with ICO[5–2,500 parts/million (ppm)]. Comparisons were made with INO(5 and 20 ppm) and combined INO(5 ppm) and ICO(100 and 2,500 ppm). We found that ICOdid not alter left lung blood flow or PVR at any of the study doses. In contrast, low-dose INOdecreased PVR by 47% ( P < 0.005). The combination of INOand ICOdid not enhance the vasodilator response to INO. To determine whether endogenous CO contributes to vascular tone in the fetal lung, zinc protoporphyrin IX, an inhibitor of heme oxygenase, was infused into the LPA in three lambs. Zinc protoporphyrin IX had no effect on baseline PVR, aortic pressure, or the pressure gradient across the ductus arteriosus. We conclude that ICOdoes not cause vasodilation in the near-term ovine transitional circulation, and endogenous CO does not contribute significantly to baseline pulmonary vascular tone or ductus arteriosus tone in the late-gestation ovine fetus.

scholarly journals Effect of Different Local Vibration Frequencies on the Multiscale Regularity of Plantar Skin Blood Flow

Entropy ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. 1288
Author(s):  
Fuyuan Liao ◽  
Keying Zhang ◽  
Lingling Zhou ◽  
Yanni Chen ◽  
Jeannette Elliott ◽  
...  
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Metatarsal Head ◽  
Structural Features ◽  
Frequency Interval ◽  
Local Vibration ◽  
First Metatarsal ◽  
Before And After ◽  
The Right ◽  
Selection Of

Local vibration has shown promise in improving skin blood flow (SBF). However, there is no consensus on the selection of the best vibration frequency. An important reason may be that previous studies utilized time- and frequency-domain parameters to characterize vibration-induced SBF responses. These parameters are unable to characterize the structural features of the SBF response to local vibrations, thus contributing to the inconsistent findings seen in vibration research. The objective of this study was to provide evidence that nonlinear dynamics of SBF responses would be an important aspect for assessing the effect of local vibration on SBF. Local vibrations at 100 Hz, 35 Hz, and 0 Hz (sham vibration) with an amplitude of 1 mm were randomly applied to the right first metatarsal head of 12 healthy participants for 10 min. SBF at the same site was measured for 10 min before and after local vibration. The degree of regularity of SBF was quantified using a multiscale sample entropy algorithm. The results showed that 100 Hz vibration significantly increased multiscale regularity of SBF but 35 Hz and 0 Hz (sham vibration) did not. The significant increase of regularity of SBF after 100 Hz vibration was mainly attributed to increased regularity of SBF oscillations within the frequency interval at 0.0095–0.15 Hz. These findings support the use of multiscale regularity to assess effectiveness of local vibration on improving skin blood flow.

Cardiovascular hemodynamics in the fetal lamb before and after lung expansion

1965 ◽  
Vol 208 (1) ◽  
pp. 122-129 ◽  
Author(s):  
N. S. Assali ◽  
John A. Morris ◽  
Russell Beck
Keyword(s):  
Cardiac Output ◽  
Vascular Resistance ◽  
Lung Ventilation ◽  
Systemic Resistance ◽  
Cardiovascular Hemodynamics ◽  
Cord Clamping ◽  
Lung Expansion ◽  
Fetal Lamb ◽  
Before And After ◽  
The Right

Cardiovascular hemodynamic studies were carried out on fetal lambs before and after lung ventilation as well as before and after cord clamping. The findings are as follows: 1) Before lung expansion, pressures, output, and work in the right side of the heart are greater than those in the left side. This relation is reversed promptly after lung expansion. 2) When compared to adults, effective fetal cardiac output is high before lung expansion and falls significantly after lung expansion. 3) In the fetus, total pulmonary vascular resistance is considerably higher than systemic resistance. This relation is reversed immediately after lung expansion. 4) In the fetus, the flow of blood in the aorta and pulmonary artery is largely governed by inertial factors. 5) Cord clamping increases systemic resistance through elimination of low vascular resistance of the placental bed.

scholarly journals Steep head-down tilt has persisting effects on the distribution of pulmonary blood flow

2006 ◽  
Vol 101 (2) ◽  
pp. 583-589 ◽  
Author(s):  
A. Cortney Henderson ◽  
David L. Levin ◽  
Susan R. Hopkins ◽  
I. Mark Olfert ◽  
Richard B. Buxton ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Blood Flow ◽  
Regional Blood Flow ◽  
Flow Distribution ◽  
Normal Subjects ◽  
Relative Dispersion ◽  
Lung Water ◽  
Before And After ◽  
Capillary Pressures ◽  
The Right

Head-down tilt has been shown to increase lung water content in animals and alter the distribution of ventilation in humans; however, its effects on the distribution of pulmonary blood flow in humans are unknown. We hypothesized that head-down tilt would increase the heterogeneity of pulmonary blood flow in humans, an effect analogous to the changes seen in the distribution of ventilation, by increasing capillary hydrostatic pressure and fluid efflux in the lung. To test this, we evaluated changes in the distribution of pulmonary blood flow in seven normal subjects before and after 1 h of 30° head-down tilt using the magnetic resonance imaging technique of arterial spin labeling. Data were acquired in triplicate before tilt and at 10-min intervals for 1 h after tilt. Pulmonary blood flow heterogeneity was quantified by the relative dispersion (standard deviation/mean) of signal intensity for all voxels within the right lung. Relative dispersion was significantly increased by 29% after tilt and remained elevated during the 1 h of measurements after tilt (0.84 ± 0.06 pretilt, 1.09 ± 0.09 calculated for all time points posttilt, P < 0.05). We speculate that the mechanism most likely responsible for our findings is that increased pulmonary capillary pressures and fluid efflux in the lung resulting from head-down tilt alters regional blood flow distribution.

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