scholarly journals Left ventricular dysfunction after two hours of polarizing or depolarizing cardioplegic arrest in a porcine model

Perfusion ◽  
2018 ◽  
Vol 34 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Terje Aass ◽  
Lodve Stangeland ◽  
Christian Arvei Moen ◽  
Atle Solholm ◽  
Geir Olav Dahle ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Myocardial Function ◽  
Blood Flow Rate ◽  
Left Ventricular ◽  
Tissue Blood Flow ◽  
Myocardial Tissue ◽  
Stroke Work ◽  
Cardioplegic Arrest ◽  
Blood Cardioplegia

Introduction: This experimental study compares myocardial function after prolonged arrest by St. Thomas’ Hospital polarizing cardioplegic solution (esmolol, adenosine, Mg2+) with depolarizing (hyperkalaemic) St. Thomas’ Hospital No 2, both administered as cold oxygenated blood cardioplegia. Methods: Twenty anaesthetized pigs on tepid (34°C) cardiopulmonary bypass (CPB) were randomised to cardioplegic arrest for 120 min with antegrade, repeated, cold, oxygenated, polarizing (STH-POL) or depolarizing (STH-2) blood cardioplegia every 20 min. Cardiac function was evaluated at Baseline and 60, 150 and 240 min after weaning from CPB, using a pressure-conductance catheter and epicardial echocardiography. Regional tissue blood flow, cleaved caspase-3 activity and levels of malondialdehyde were evaluated in myocardial tissue samples. Results: Preload recruitable stroke work (PRSW) was increased after polarizing compared to depolarizing cardioplegia 150 min after declamping (73.0±3.2 vs. 64.3±2.4 mmHg, p=0.047). Myocardial tissue blood flow rate was high in both groups compared to the Baseline levels and decreased significantly in the STH-POL group only, from 60 min to 150 min after declamping (p<0.005). Blood flow was significantly reduced in the STH-POL compared to the STH-2 group 240 min after declamping (p<0.05). Left ventricular mechanical efficiency, the ratio between total pressure-volume area and blood flow rate, gradually decreased after STH-2 cardioplegia and was significantly reduced compared to STH-POL cardioplegia after 150 and 240 min (p<0.05 for both). Conclusion: Myocardial protection for two hours of polarizing cardioplegic arrest with STH-POL in oxygenated blood is non-inferior compared to STH-2 blood cardioplegia. STH-POL cardioplegia alleviates the mismatch between myocardial function and perfusion after weaning from CPB

Nocturnal variations in human lower leg subcutaneous blood flow related to sleep stages

1992 ◽  
Vol 73 (4) ◽  
pp. 1246-1252 ◽  
Author(s):  
J. H. Sindrup ◽  
J. Kastrup ◽  
P. L. Madsen ◽  
H. Christensen ◽  
B. Jorgensen ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
First Episode ◽  
Tissue Blood Flow ◽  
Sleep Stages ◽  
Deep Sleep ◽  
Arterial Blood ◽  
Subcutaneous Blood Flow ◽  
The Moment

Nocturnal subcutaneous adipose tissue blood flow rate was measured in the lower legs of 10 normal human subjects together with systemic arterial blood pressure, heart rate, and registration of sleep stages under ambulatory conditions. The 133Xe washout technique, portable CdTe(Cl) detectors, and a portable data storage unit were used for measurement of blood flow rates. The sleep recordings were performed with a portable computerized sleep analysis system. In accordance with the results of previous studies, a hyperemic blood flow rate phase (mean increase 140%) for 100 min was observed approximately 60 min after the subjects went to bed. The moment of onset of the hyperemic phase was closely related to the moment of onset of the first episode of deep sleep (stages 3 and 4). There was a significant (P < 0.01) overrepresentation of deep sleep in the hyperemic phase compared with adjacent phases, and rapid-eye-movement sleep predominantly occurred in the latter part of the night, when the subcutaneous blood flow rate was stable. The results of the present study are in accordance with current theories of the interrelationship between the thermoregulatory and the arousal state control systems and, thus, might suggest that the nightly subcutaneous hyperemia represents a thermoregulatory effector mechanism.

Nocturnal variations in peripheral blood flow, systemic blood pressure, and heart rate in humans

1991 ◽  
Vol 261 (4) ◽  
pp. H982-H988
Author(s):  
J. H. Sindrup ◽  
J. Kastrup ◽  
H. Christensen ◽  
B. Jorgensen
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Arterial Blood Pressure ◽  
Flow Rate ◽  
Mean Arterial Blood Pressure ◽  
Blood Flow Rate ◽  
Tissue Blood Flow ◽  
Peripheral Blood Flow ◽  
Arterial Blood

Subcutaneous adipose tissue blood flow rate, together with systemic arterial blood pressure and heart rate under ambulatory conditions, was measured in the lower legs of 15 normal human subjects for 12-20 h. The 133Xe-washout technique, portable CdTe(Cl) detectors, and a portable data storage unit were used for measurement of blood flow rates. An automatic portable blood pressure recorder and processor unit was used for measurement of systolic blood pressure, diastolic blood pressure, and heart rate every 15 min. The change from upright to supine position at the beginning of the night period was associated with a 30-40% increase in blood flow rate and a highly significant decrease in mean arterial blood pressure and heart rate (P less than 0.001 for all). Approximately 100 min after the subjects went to sleep an additional blood flow rate increment (mean 56%) and a simultaneous significant decrease in mean arterial blood pressure (P less than 0.001) were observed. The duration of this hyperemic phase was 116 min. A highly significant reduction of the subcutaneous vascular resistance (50%) was demonstrated during the hyperemic blood flow rate phase compared with the surrounding phases (P less than 0.0001). The synchronism of the nocturnal subcutaneous hyperemia and the decrease in systemic mean arterial blood pressure point to a common, possibly central nervous or humoral, eliciting mechanism.

scholarly journals Flow Manipulation and the Association with Myocardial Systolic Function During Extracorporeal Life Support

2021 ◽  
Author(s):  
Pauline Yeung NG ◽  
Tammy Sin Kwan MA ◽  
April IP ◽  
Shu FANG ◽  
Andy Chak Cheung LI ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Blood Flow Rate ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Systolic Function ◽  
Ventricular Ejection Fraction

Abstract Background:Peripheral veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used to support circulatory failure refractory to conventional therapy. However, data on the heart-ECMO interaction at different levels of ECMO blood flow during the immediate period after ECMO initiation are sparse. We evaluated the effects of varying ECMO blood flow rate on left ventricular systolic function.Methods:Adult patients who were supported by peripheral V-A ECMO in a tertiary referral center were recruited. Serial hemodynamic and cardiac performance parameters were measured by transthoracic echocardiogram within the first 48 hours after implementation of V-A ECMO. Measurements at 100%, 120%, and 50% of target blood flow (TBF) were compared.Results:A total of 45 patients were included, 32 (71.1%) were male, and the median age was 57 (50-64) years. The main indications for V-A ECMO were myocardial infarction 25 (55.6%) and myocarditis 6 (13.3%). With a decrease in extracorporeal blood flow from 100% to 50% of TBF, mean arterial pressure dropped from 75±18 to 67±20 mmHg (p<0.001), but stroke volume increased from 15 (8-25) to 21 (13-34) mL (p<0.001), and cardiac index increased from 0.8 (0.5-1.3) to 1.2 (0.7-1.7) L/min/m2 (p<0.001). All indices of left ventricular contractility improved at 50% compared with 100% TBF: the global longitudinal strain improved from -2.8 (-5.4-0) to -4.7 (-8.2- -1.1)% (p<0.001); left ventricular ejection fraction increased from 16.8 (10.0-28.5) to 28.2 (18.0-35.5)% (p<0.001); and left ventricular outflow tract velocity time integral increased from 4.7 (2.7-7.8) to 7.7 (3.9-11.3) cm (p<0.001). The addition of echocardiographic parameters improved the discrimination of the SAVE score in predicting hospital mortality (AUROC 0.71 vs 0.58).Conclusions:In the initial period of V-A ECMO support, left ventricular systolic function quantified bedside echocardiography was inversely related to ECMO blood flow rate. The heart-ECMO interaction should be considered when determining goals of ECMO flow after initiation.

scholarly journals COPD and preclinical cardiovascular disease

2021 ◽  
Vol 2 (2) ◽  
pp. 70-79
Author(s):  
V. A. Nevzorova ◽  
N. V. Zakharchuk ◽  
E. U. Shapkina ◽  
E. A. Kondrashova ◽  
D. V. Kondrashov
Keyword(s):  
Cardiovascular Disease ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Vascular Resistance ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Left Ventricular ◽  
Peripheral Vascular Resistance ◽  
Peripheral Vascular ◽  
Copd Patients

Objective: to assess cerebral blood flow and reveal early myocardial remodeling in COPD patients with varying degrees of airflow restriction. Materials and methods: the research included 105 patients with COPD from 1 to 4 degrees of severity, depending on the degree of restriction of FEV1 without CVD, diabetes mellitus, chronic kidney disease, obesity, other systemic and oncological diseases. Average age was 57.12 ± 0.68 years, men 45%. 5 groups were identified: mild severity of COPD (GOLD1, = 24), moderate (COLD2, n = 39), severe (GOLD3, n = 30), very severe (GOLD4, n = 12). Control group (n = 37) was tobacco free and CVD. Blood pressure and ultrasound tracranial dopplerography were performed in all groups. Transtoral echocardiography with assessment of global and local LV longitudinal deformation by the strain method and determination of left ventricular diastolic dysfunction (DDLV) was performed in GOLD1 and GOLD2 groups. Parameters of average values of deformation in basal, medial and apical segments are evaluated. Results were processed with Microsoft Excel 2016 and STATISTICA 10 (StatSoft, Inc., USA). Results: arterial hypertension (AH) was detected in 56.4% of patients in the COLD2 group; 56.7% of patients in the GOLD3 group and 100% of patients in the GOLD4. Сhanges in cerebral blood flow were not found in the GOLD1-3 groups. Significant increase of linear blood flow rate of middle cerebral arteries and index of peripheral vascular resistance were detected in group GOLD4 relative to control and GOLD1-3 groups (p < 0.05). DDLV of 1 type was revealed in 27.7% of patients of COPD and was higher at patients with COPD and AH - 62.5% (χ²=11.5, р =0.009). Pathological patterns were identified at the level of the basal and medial parts of the left ventricle in patients with COPD. Conclusion: preclinical signs of target organ involvement identified in COPD patients without cardiovascular disease. Changes in cerebral blood flow in the form of an increase in linear blood flow rate and peripheral vascular resistance index were detected in the GOLD4 group. DDLV of 1 type was detected in the GOLD1-2 groups and was found more frequently in the combination of COPD with AH. Pathological patterns were identified at the basal and medial left ventricular levels in a combination of COPD and AH. Changes in target organs indicate the need for an in-depth search to reclassify cardiovascular risk and identify an individual prevention plan.

Nocturnal variations in subcutaneous blood flow rate in lower leg of normal human subjects

1991 ◽  
Vol 260 (2) ◽  
pp. H480-H485 ◽  
Author(s):  
J. H. Sindrup ◽  
J. Kastrup ◽  
B. Jorgensen ◽  
J. Bulow ◽  
N. A. Lassen
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Human Subjects ◽  
Blood Flow Rate ◽  
Lower Leg ◽  
Tissue Blood Flow ◽  
Subcutaneous Blood Flow ◽  
Normal Human ◽  
Night Period ◽  
133Xe Washout

Subcutaneous adipose tissue blood flow rate was measured in the lower leg of 22 normal human subjects over 12- to 20-h ambulatory conditions. The 133Xe washout technique, portable CdTe(Cl) detectors, and a portable data storage unit were used. The tracer depot was applied on the medial aspect of the right lower leg 10 cm proximal to the malleolar level by means of the epicutaneous, atraumatic labeling technique. The change from upright to supine position from day 1 in the beginning of the night period elicited an instantaneous blood flow rate increment of 30-40% in accordance with a decrease in central and local postural sympathetic vasoconstrictor activity. During sleep, characteristic variations in subcutaneous blood flow were disclosed. The 133Xe washout curve could be divided into three segments with significantly different slopes. Approximately 90 min after the subject went to sleep, an additional blood flow rate increment of considerable magnitude was observed. The mean increase was 84%, but in several cases a greater than 200% increment was measured (maximum 244%). The intra-individual coefficient of variation for the nocturnal blood flow response was in triplicate measurements 25% (n = 9). The hyperemic phase lasted approximately 100 min after which the blood flow rate returned to the level measured at the beginning of the night period. The blood flow rates measured on the second day did not differ from those on the first day. Control measurements performed under similar thermal conditions, but with the subjects kept awake, did not reveal any hyperemic phases. This points toward changes in cardiovascular regulatory mechanisms during sleep.(ABSTRACT TRUNCATED AT 250 WORDS)

Alteration of ischemic cardiac function in normal heart by daily exercise

1983 ◽  
Vol 55 (1) ◽  
pp. 52-60 ◽  
Author(s):  
D. R. Knight ◽  
H. L. Stone
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Myocardial Function ◽  
Exercise Program ◽  
Segment Length ◽  
Tissue Blood Flow ◽  
Myocardial Tissue ◽  
Daily Exercise ◽  
Coronary Collateral Blood Flow ◽  
Made In

Myocardial function, tissue blood flow, and heart rate measurements were studied during control and a 2-min occlusion of the left circumflex coronary artery in conscious dogs. These measurements were made in the same dogs before exercise in the untrained state (UT) and after a 4-wk treadmill exercise program in the partially trained condition (PT). Ultrasonic segment length gauges were used to measure myocardial function in the ischemic zone, defined by staining the myocardial tissue. Microspheres (15 microns), labeled with different isotopes, were used to measure the myocardial tissue flow in the normal and ischemic zones. Myocardial function in the ischemic zone of 20 dogs was reduced 71 +/- 6% in the UT condition; however, after PT, the percent reduction in segment length function was only 33 +/- 4% during occlusion. During occlusion, an increase in heart rate of 46 +/- 7% in the UT condition was observed; yet after PT, heart rate increased only 19 +/- 5%. In 5 UT dogs with heart rate held constant (150 beats/min), the decrease from control in tissue blood flow to the ischemic zone in the subendocardium during occlusion was 60 +/- 7%. After PT, the decrease from control in tissue blood flow in the same dogs was 34 +/- 6%. These data indicate that the improved myocardial function during ischemia was a result of the improved coronary collateral blood flow into the ischemic zone after PT.

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