Clinical Monitoring of Left Ventricular Arterial Coupling as a New Index of a Stresssed Cardiovascular System.

Dilated cardiomyopathy is the most common type of the heart failure which can be characterized by impaired ventricular contractility. Mechanical circulatory support devices were introduced into practice for the heart failure patients to bridge the time between the decision to transplant and the actual transplantation which is not sufficient due to the state of donor organ supply. In this study, the hemodynamic response of a cardiovascular system that includes a dilated cardiomyopathic heart under support of a newly developed continuous flow left ventricular assist device—Heart Turcica Axial—was evaluated employing computer simulations. For the evaluation, a numerical model which describes the pressure-flow rate relations of Heart Turcica Axial, a cardiovascular system model describing the healthy and pathological hemodynamics, and a baroreflex model regulating the heart rate were used. Heart Turcica Axial was operated between 8000 rpm and 11000 rpm speeds with 1000 rpm increments for assessing the pump performance and response of the cardiovascular system. The results also give an insight about the range of the possible operating speeds of Heart Turcica Axial in a clinical application. Based on the findings, operating speed of Heart Turcica Axial should be between 10000 rpm and 11000 rpm.

Download Full-text

The Effect of Single Use of Sorbilact and Its Combination with L-Arginine on the State of the Cardiovascular System in Endogenous Intoxication Syndrome of Purulent-Septic Genesis

Galician Medical Journal ◽

10.21802/gmj.2018.2.7 ◽

2018 ◽

Vol 25 (2) ◽

Author(s):

Natalya Maksymchuk ◽

Viktor Konovchuk

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Cardiovascular System ◽

Standard Therapy ◽

Specific Effect ◽

Left Ventricular ◽

Systemic Inflammatory Response ◽

Septic Complications ◽

Endogenous Intoxication ◽

Group I

The preparations of polyhydric alcohols, namely sorbitol-based ones, and their combination with adjuvant therapy, namely L-arginine are sufficiently promising for treatment of purulent-septic complications. The systemic nature of their action makes it appropriate to carry out studies of specific effect on the circulatory system, since their wide homeostatic and pharmacodynamic spectrum is beyond doubt for other systems and organs within the “efficiency-safety” algorithm.The objective of the research was to study the effect of combined use of sorbilact and L-arginine on the cardiovascular system of patients with endogenous intoxication syndrome during the period of developing early secondary autoaggression.Materials and methods. The study included 117 patients who were divided into the following groups: Group I consisted of 31 patients with systemic inflammatory response syndrome; Group II included 27 patients with endogenous intoxication syndrome treated according to 2016 Surviving Sepsis Campaign; Group ІІI comprised 29 patients with endogenous intoxication syndrome who received sorbilact in addition to standard therapy; Group IV included 30 patients with systemic inflammatory response syndrome who received standard therapy as well as sorbilact and L-arginine.Results. Co-administration of sorbilact and L-arginine was accompanied by an increase in stroke volume and cardiac output, activation of left ventricular minute work alongside with a moderate decrease in mean arterial pressure and systemic vascular resistance.Conclusions. The application of sorbilact and L-arginine in patients with endogenous intoxication syndrome provides hemodynamic stability.

Download Full-text

The cardiovascular system in patients with symptomatic and mild primary hyperparathyroidism

Problems of Endocrinology ◽

10.14341/probl200955325-29 ◽

2009 ◽

Vol 55 (3) ◽

pp. 25-29 ◽

Cited By ~ 1

Author(s):

I V Voronenko ◽

N G Mokrysheva ◽

L Ya Rozhinskaya ◽

A L Syrkin

Keyword(s):

Parathyroid Hormone ◽

Left Ventricular Hypertrophy ◽

Primary Hyperparathyroidism ◽

Cardiovascular System ◽

Qt Interval ◽

Ventricular Hypertrophy ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Ionized Calcium ◽

Mild Primary Hyperparathyroidism

The cardiovascular system was analyzed in patients with symptomatic (n = 31) and mild primary hyperparathyroidism (n = 34) whose mean age was 54.6 years; 95% females). In the patients with symptomatic primary hyperparathyroidism, the PQ interval was longer and the QT interval was significantly shorter than those in patients with mild hyperparathyroidism. Left ventricular hypertrophy was noted in 45.2% of patients with symptomatic and in 15.2% of those with mild hyperparathyroidism (p = 0.013). Left ventricular diastolic dysfunction was also more common in the group of symptomatic hyperparathyroidism. There was a statistically significant correlation between the levels of parathyroid hormone, total and ionized calcium and the duration of QT interval and the determinants of diastolic function and left ventricular hypertrophy. The revealed cardiovascular disorders in patients with primary hyperparathyroidism are presumed to depend on the increase rate of parathyroid hormone and total and ionized calcium.

Download Full-text

Indicators of the left ventricular-arterial coupling interaction in chronic forms of ischemic heart disease: relationships of the protradenomedullin and N-terminal probrain natriuretic peptide

Kardiologiia ◽

10.18087/cardio.2627 ◽

2019 ◽

Vol 59 (6S) ◽

pp. 41-50

Author(s):

E. I. Myasoedova ◽

L. P. Voronina ◽

O. S. Polunina ◽

Yu. G. Shvarts

Keyword(s):

Myocardial Infarction ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Ischemic Cardiomyopathy ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Coupling Interaction ◽

Left Ventricular Arterial Coupling

Purpose of the study. Analyze the parameters of the interaction between the left ventricle and the arterial system in patients with chronic forms of coronary heart disease and to identify relationships with levels of proadrenomedullin (MR‑proADM) and N‑terminal precursor of the brain natriuretic peptide B (NT‑proBNP).Materials and methods.240 patients with chronic forms of coronary heart disease (median – 55,9 [43; 63] years) and Q‑forming myocardial infarction in the past were examined. Of these, 110 patients with myocardial infarction and preserved lef ventricular ejection fraction and 130 patients with ischemic cardiomyopathy. All patients were calculated parameters of lef ventricular‑arterial interaction and the determination in blood serum levels of MR‑proADM and NT‑proBNP.Results.In patients with ischemic cardiomyopathy, an increase in the lef ventricular‑arterial interaction index was detected (2,51 [1,18; 5,00]), which reﬂects a decrease in the functional abilities and efficiency of the heart. In patients with myocardial infarction and a preserved left ventricular ejection fraction, this indicator was in the range of normal values (0,78 [0,55; 1,07]), which indicates an eﬀective cardiac work. A study of MR‑proADM and NT‑proBNP levels demonstrated an increase in both groups (1,72 [1,56; 1,98] nmol/l and 779,3 [473; 2193] pg/ml in the group of patients with ischemic cardiomyopathy; 0,89 [0,51; 1,35] nmol/l and 246 [118; 430] pg/ml in the group of patients with myocardial infarction and preserved left ventricular ejection fraction), and the correlation analysis with left ventricular‑arterial coupling interaction parameters allowed identify statistically significant connections (in the group of patients with ischemic cardiomyopathy: with the level of MR‑proADM ‑ r=0,67, p=0,006, with the level of NT‑proBNP ‑ r=0,78, p<0,001; in the group of patients with myocardial infarction and preserved left ventricular ejection fraction: with MR‑proADM level ‑ r=‑0,52, p=0,024, with NT‑proBNP level ‑ r =‑0,38, p=0,037).Conclusion.The findings suggest a pathogenetic association between the biomarkers under study and the parameters of left ventricular‑arterial coupling interaction.

Download Full-text

Desflurane, Sevoflurane, and Isoflurane Impair Canine Left Ventricular-Arterial Coupling and Mechanical Efficiency

Anesthesiology ◽

10.1097/00000542-199608000-00023 ◽

1996 ◽

Vol 85 (2) ◽

pp. 403-413 ◽

Cited By ~ 55

Author(s):

Douglas A. Hettrick ◽

Paul S. Pagel ◽

David C. Warltier

Keyword(s):

Arterial Pressure ◽

Myocardial Contractility ◽

Minimum Alveolar Concentration ◽

Systolic Pressure ◽

Mechanical Efficiency ◽

Left Ventricular ◽

Stroke Work ◽

Arterial Elastance ◽

Ventricular Afterload ◽

Left Ventricular Arterial Coupling

Background The effects of desflurane, sevoflurane, and isoflurane on left ventricular-arterial coupling and mechanical efficiency were examined and compared in acutely instrumented dogs. Methods Twenty-four open-chest, barbiturate-anesthetized dogs were instrumented for measurement of aortic and left ventricular (LV) pressure (micromanometer-tipped catheter), dP/dtmax, and LV volume (conductance catheter). Myocardial contractility was assessed with the end-systolic pressure-volume relation (Ees) and preload recruitable stroke work (Msw) generated from a series of LV pressure-volume diagrams. Left ventricular-arterial coupling and mechanical efficiency were determined by the ratio of Ees to effective arterial elastance (Ea; the ratio of end-systolic arterial pressure to stroke volume) and the ratio of stroke work (SW) to pressure-volume area (PVA), respectively. Results Desflurane, sevoflurane, and isoflurane reduced heart rate, mean arterial pressure, and left ventricular systolic pressure. All three anesthetics caused similar decreases in myocardial contractility and left ventricular afterload, as indicated by reductions in Ees, Msw, and dP/dtmax and Ea, respectively. Despite causing simultaneous declines in Ees and Ea, desflurane decreased Ees/Ea (1.02 +/- 0.16 during control to 0.62 +/- 0.14 at 1.2 minimum alveolar concentration) and SW/PVA (0.51 +/- 0.04 during control to 0.43 +/- 0.05 at 1.2 minimum alveolar concentration). Similar results were observed with sevoflurane and isoflurane. Conclusions The present findings indicate that volatile anesthetics preserve optimum left ventricular-arterial coupling and efficiency at low anesthetic concentrations (< 0.9 minimum alveolar concentration); however, mechanical matching of energy transfer from the left ventricle to the arterial circulation degenerates at higher end-tidal concentrations. These detrimental alterations in left ventricular-arterial coupling produced by desflurane, sevoflurane, and isoflurane contribute to reductions in overall cardiac performance observed with these agents in vivo.

Download Full-text

CHRONIC KIDNEY DISEASE AND THE STATE OF THE CARDIOVASCULAR SYSTEM IN LOCOMOTIVE CREW WORKERS

10.31089/978-5-6042929-2-1-2021-1-208-211 ◽

2021 ◽

Author(s):

V.A. Zhmurov ◽

◽

D.V. Zhmurov ◽

V.G. Yarkova

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Cardiovascular System ◽

Cardiovascular Events ◽

Ventricular Remodeling ◽

Myocardial Hypertrophy ◽

Left Ventricular Remodeling ◽

Left Ventricular ◽

Professional Activities ◽

Ckd Stage

Abstract: 967 employees of locomotive crews (drivers and their assistants of the Sverdlovsk railway of JSC «Russian Railways») were examined. It was revealed that CKD occurs in 12, 09% of employees of locomotive crews. As the CKD stage increases, the progression of changes in the cardiovascular system was found in locomotive crew workers. A high percentage of the prognostically unfavorable variant of left ventricular remodeling - eccentric myocardial hypertrophy (25% - 39.1%, depending on the stage of CKD) was found. These changes may be a factor of adverse cardiovascular events in employees of locomotive crews, which must be taken into account when admitting to professional activities.

Download Full-text

In the Loop—Left Ventricular Pressures

Just Enough Physiology ◽

10.1093/med/9780199797790.003.0005 ◽

2011 ◽

pp. 42-47

Author(s):

James R. Munis

Keyword(s):

Heart Rate ◽

Cardiac Output ◽

Aortic Valve ◽

Left Ventricle ◽

Stroke Volume ◽

Cardiovascular System ◽

Aortic Root ◽

Left Ventricular ◽

Root Pressure ◽

The Third

We've already looked at 2 types of pressure that affect physiology (atmospheric and hydrostatic pressure). Now let's consider the third: vascular pressures that result from mechanical events in the cardiovascular system. As you already know, cardiac output can be defined as the product of heart rate times stroke volume. Heart rate is self-explanatory. Stroke volume is determined by 3 factors—preload, afterload, and inotropy—and these determinants are in turn dependent on how the left ventricle handles pressure. In a pressure-volume loop, ‘afterload’ is represented by the pressure at the end of isovolumic contraction—just when the aortic valve opens (because the ventricular pressure is now higher than aortic root pressure). These loops not only are straightforward but are easier to construct just by thinking them through, rather than by memorization.

Download Full-text