Document Detail


Acute and chronic response of the right ventricle to surgically induced pressure and volume overload--an analysis of pressure-volume relations.
MedLine Citation:
PMID:  20089680     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We aimed to determine the response of the right ventricle (RV) to surgically induced pressure and volume overload in both acute and chronic settings. Four-month-old sheep were operated via left anterior thoracotomy. Pressure overload of the RV was established by banding of the pulmonary trunk. Volume overload was induced by the implantation of a transannular patch to the right ventricular outflow tract. Right ventricular function was obtained with conductance catheters before and after surgery as well as three months postoperatively. Acute pressure overload resulted in an increase of end-systolic volume (ESV) (P=0.002) and end-diastolic volume (EDV) (P=0.004), increments in contractile indexes [maximal slope of systolic pressure increment (dP/dt(max)), P=0.002; slope of end-systolic pressure volume relation (Ees), P=0.002; preload recruitable stroke work (PRSW), P=0.002] and an acceleration of early diastole [relaxation time (tau), P=0.012; maximal slope of diastolic pressure decrement (dP/dt(min)), P=0.002]. Acute volume overload revealed better contractility and more prominent increases in preload (ESV, EDV; both P=0.008). Three months postoperatively, pressure overloaded hearts demonstrated superior systolic (Ees, P=0.022; PRSW, P=0.013) and diastolic reserves (dP/dt(min), P=0.013; slope of end-diastolic pressure volume relation (Eed), P=0.005; P(20), P=0.003) than volume overloaded hearts. Acute pressure overload leads to enhanced contractility of the RV as a result of the Anrep effect and the Frank-Starling mechanism whereas volume overload institutes only the latter. The chronically pressure overloaded RV exposes more contractile and elastic reserves than the chronically volume overloaded RV under stress conditions.
Authors:
Can Yerebakan; Christian Klopsch; Sabine Niefeldt; Vilia Zeisig; Brigitte Vollmar; Andreas Liebold; Eugen Sandica; Gustav Steinhoff
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-01-20
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  10     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-25     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  519-25     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Medical Faculty, University of Rostock, Schillingallee 35, 18057 Rostock, Germany. can.yerebakan@med.uni-rostock.de
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Animals
Cardiotonic Agents / administration & dosage
Chronic Disease
Constriction
Disease Models, Animal
Dobutamine / administration & dosage
Female
Heart Catheterization
Heart Defects, Congenital / complications,  physiopathology
Male
Myocardial Contraction* / drug effects
Pericardiectomy
Pulmonary Artery / surgery
Sheep
Sternotomy
Stroke Volume* / drug effects
Thoracotomy
Time Factors
Ventricular Dysfunction, Right / etiology,  physiopathology*
Ventricular Function, Right* / drug effects
Ventricular Outflow Obstruction / complications,  physiopathology
Ventricular Pressure* / drug effects
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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