Regulation of Cardiac Output in Cardiac Failure

Author(s):  
R. Gourgon ◽  
J. P. Merillon ◽  
Y. Pansard ◽  
R. Prasquier ◽  
J. Y. Baglin ◽  
...  
2013 ◽  
Vol 24 (4) ◽  
pp. 654-660 ◽  
Author(s):  
Stany Sandrio ◽  
Wolfgang Springer ◽  
Matthias Karck ◽  
Matthias Gorenflo ◽  
Alexander Weymann ◽  
...  

AbstractBackground: The aim of this study was to evaluate our experience in central extracorporeal life support with an integrated left ventricular vent in children with cardiac failure. Methods: Eight children acquired extracorporeal life support with a left ventricular vent, either after cardiac surgery (n = 4) or during an acute cardiac illness (n = 4). The ascending aorta and right atrium were cannulated. The left ventricular vent was inserted through the right superior pulmonary vein and connected to the venous line on the extracorporeal life support such that active left heart decompression was achieved. Results: No patient died while on support, seven patients were successfully weaned from it and one patient was transitioned to a biventricular assist device. The median length of support was 6 days (range 5–10 days). One patient died while in the hospital, despite successful weaning from extracorporeal life support. No intra-cardiac thrombus or embolic stroke was observed. No patient developed relevant intracranial bleeding resulting in neurological dysfunction during and after extracorporeal life support. Conclusions: In case of a low cardiac output and an insufficient inter-atrial shunt, additional left ventricular decompression via a vent could help avoid left heart distension and might promote myocardial recovery. In pulmonary dysfunction, separate blood gas analyses from the venous cannula and the left ventricular vent help detect possible coronary hypoxia when the left ventricle begins to recover. We recommend the use of central extracorporeal life support with an integrated left ventricular vent in children with intractable cardiac failure.


2012 ◽  
Vol 53 (5) ◽  
pp. 293-298 ◽  
Author(s):  
Taira Fukuda ◽  
Akihiro Matsumoto ◽  
Miwa Kurano ◽  
Haruhito Takano ◽  
Haruko Iida ◽  
...  

2019 ◽  
Vol 189 (6) ◽  
pp. 757-769 ◽  
Author(s):  
Andreas Ekström ◽  
Albin Gräns ◽  
Erik Sandblom

Abstract Coronary perfusion and cardiac autonomic regulation may benefit myocardial oxygen delivery and thermal performance of the teleost heart, and thus influence whole animal heat tolerance. Yet, no study has examined how coronary perfusion affects cardiac output during warming in vivo. Moreover, while β-adrenergic stimulation could protect cardiac contractility, and cholinergic decrease in heart rate may enhance myocardial oxygen diffusion at critically high temperatures, previous studies in rainbow trout (Oncorhynchus mykiss) using pharmacological antagonists to block cholinergic and β-adrenergic regulation showed contradictory results with regard to cardiac performance and heat tolerance. This could reflect intra-specific differences in the extent to which altered coronary perfusion buffered potential negative effects of the pharmacological blockade. Here, we first tested how cardiac performance and the critical thermal maximum (CTmax) were affected following a coronary ligation. We then assessed how these performances were influenced by pharmacological cholinergic or β-adrenergic blockade, hypothesising that the effects of the pharmacological treatment would be more pronounced in coronary ligated trout compared to trout with intact coronaries. Coronary blockade reduced CTmax by 1.5 °C, constrained stroke volume and cardiac output across temperatures, led to earlier cardiac failure and was associated with reduced blood oxygen-carrying capacity. Nonetheless, CTmax and the temperatures for cardiac failure were not affected by autonomic blockade. Collectively, our data show that coronary perfusion improves heat tolerance and cardiac performance in trout, while evidence for beneficial effects of altered cardiac autonomic tone during warming remains inconclusive.


2009 ◽  
pp. 54-56
Author(s):  
M.M. Dale ◽  
D.G. Haylett

1963 ◽  
Vol 1 (17) ◽  
pp. 66-67

Theophylline and its derivatives dilate the bronchi of asthmatic subjects when given in high enough doses. They may relieve Cheyne-Stokes respiration, and they may increase cardiac output and cause a diuresis in patients with cardiac failure. Since theophylline is not very soluble and irritates the stomach, the more soluble aminophylline, a loose combination of theophylline with ethylene diamine, has been used. Unfortunately in the stomach this readily breaks down to the parent substance and gastric irritation occurs. In practice effective doses of aminophylline can be given only intravenously or by suppositories. If theophylline derivatives could be taken by mouth it would be much more convenient, and for this reason other preparations have been developed.


1997 ◽  
Vol 93 (3) ◽  
pp. 195-203 ◽  
Author(s):  
Ian C. Steele ◽  
ANN Moore ◽  
Anne-Marie Nugent ◽  
Marshall S. Riley ◽  
Norman P. S. Campbell ◽  
...  

1. The role of cardiac output limitation in the pathophysiology of exercise in patients with chronic failure remains undefined. During steady-state submaximal exercise, oxygen uptake is similar in patients and control subjects, but it is not known if cardiac output is also similar. We wished to determine if the reduced exercise tolerance of patients with chronic cardiac failure during such exercise is related to reduced cardiac output, or to peripheral factors. 2. Ten male patients with stable chronic failure and ten age-matched male normal controls were studied at rest and during exercise. Each subject performed a familiarization exercise test, a symptom-limited maximal exercise test and two submaximal exercise tests. Cardiac output was measured by a carbon dioxide rebreathing method. We also measured oxygen consumption, ventilation, Borg score of perceived exertion and venous lactate concentration, and ejection fractions. 3. As expected, patients had lower peak oxygen consumption [median (range) 1.18 (0.98–1.76) versus 1.935 (1.53–2.31) 1/min; P < 0.001], lower peak venous lactate concentration but a similar overall level of perceived exertion. At the same submaximal workload, patients and control subjects had similar oxygen consumption [0.67 (0.59–0.80) versus 0.62 (0.52–0.82) 1/min] and cardiac output [6.92 (5.79–9.76) versus 7.3 (5.99–10.38) 1/min] but the patients had a greater perceived level of exertion [Borg score: 4 (1–6) versus 3 (1–5); P < 0.005], higher venous lactate concentration [1.6 (1–3.3) versus 1.14 (0.7–1.7) mmol/l; P < 0.05] and higher heart rate [106 (89–135) versus 87 (69–112) beats/min;P < 0.005]. 4. During submaximal exercise at a similar absolute workload, patients with cardiac failure have a similar oxygen uptake and cardiac output but greater anaerobiosis and increased fatigue when compared with normal subjects. These findings appear to relate predominantly to changes that occur in the periphery rather than abnormalities of central cardiac function.


1963 ◽  
Vol 204 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Hubert L. Stone ◽  
Vernon S. Bishop ◽  
Arthur C. Guyton

Radioactive microspheres were injected into the coronary systems of 11 dogs, and the quantity of microspheres entering and remaining in the coronary system was determined by radioactive counting techniques. After progressive injection of small quantities of microspheres over a period of 2–3 hr, leading finally to death by cardiac failure, the total volume of microspheres remaining in the coronary system averaged only 6.5 mm3. The pumping ability of the heart at different degrees of embolization was measured by determining successive cardiac function curves, both cardiac output curves and left ventricular minute work curves. In each experiment, both the maximum cardiac output and maximum minute work output decreased approximately proportionately after each individual injection of incremental quantities of microspheres, illustrating that the functional ability of the heart can be expressed very well by the maximum level of these function curves. In all experiments, the cardiac function curves began to deteriorate spontaneously after injection of a very critical quantity of microspheres, and a vicious cycle of deterioration occurred thereafter, resulting in rapid demise of the animal.


1996 ◽  
Vol 90 (s34) ◽  
pp. 28P-29P
Author(s):  
IC Steele ◽  
A Moore ◽  
A-M Nugent ◽  
NPS Campbell ◽  
DP Nicholls

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