| Acute elevation of coronary venous pressure does not affect left ventricular contractility in the normal and stressed swine heart: implications for the Fontan operation. | |
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MedLine Citation:
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PMID: 9338641 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: After the Fontan operation the right atrium and, thus, the coronary sinus are connected to the pulmonary arterial system, which causes the coronary venous pressure to increase. We investigated the acute effects of elevation of coronary venous pressure on baseline hemodynamics, coronary venous flow, and left ventricular contractility. METHODS: In acutely instrumented pigs, during complete right heart bypass and during constant cardiac output, pressure in the right atrium, right ventricle, and coronary sinus was altered by a height-adjustable reservoir. At various levels of coronary venous pressure (up to 4 kPa or up to 30 mm Hg), flow from the reservoir was measured and left ventricular hemodynamics and contractility were measured from catheter-derived left ventricular pressure and (conductance) volume data. Contractility of the left ventricle was assessed by the end-systolic pressure-volume relationship derived during an unloading intervention by adjusting the bypass pump speed. RESULTS: Left ventricular end-diastolic pressure increased slightly (about 5%) with each kilopascal increase in coronary venous pressure, most likely related to diastolic ventricular interaction. No other changes in hemodynamic parameters occurred. Neither coronary venous flow nor left ventricular contractility was influenced by changes in coronary venous pressure. Imposing myocardial stress with dobutamine, 10 microg/kg per minute, did not change these findings. CONCLUSION: Increasing coronary venous pressure to 4 kPa in the intact circulation with intact autoregulation does not affect coronary flow or left ventricular contractility. We found no experimental evidence for the usefulness of diversion of the coronary sinus to the left atrium during Fontan-type operations |
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Authors:
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R J Klautz; G L van Rijk-Zwikker; P Steendijk; J Wilde; D F Teitel; J Baan |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 114 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 1997 Oct |
Date Detail:
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Created Date: 1997-11-06 Completed Date: 1997-11-06 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 560-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, University Hospital Leiden, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Agonists
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pharmacology Animals Cardiopulmonary Bypass Coronary Circulation / physiology* Coronary Vessels / physiology* Dobutamine / pharmacology Fontan Procedure* Intraoperative Care Myocardial Contraction / physiology* Postoperative Care Swine Venous Pressure Ventricular Function, Left / drug effects, physiology* Ventricular Pressure / physiology |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Agonists; 34368-04-2/Dobutamine |
| Comments/Corrections | |
Comment In:
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J Thorac Cardiovasc Surg. 1998 Aug;116(2):368-9
[PMID:
9699598
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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