Document Detail


Acute pulmonary hypertension causes depression of left ventricular contractility and relaxation.
MedLine Citation:
PMID:  16953943     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: The haemodynamic effects of acute pulmonary hypertension can be largely attributed to ventricular interdependence during diastole. However, there is evidence that the two ventricles also interact during systole. The aim of the present study was to examine the effects of acute pulmonary hypertension on both components of left ventricular systole, i.e. contraction and relaxation, using load-independent indices. METHODS: Ten pigs were instrumented with biventricular conductance catheters, a pulmonary artery flow probe and a high-fidelity pulmonary pressure catheter. Haemodynamic measurements were performed in baseline conditions and during stable pulmonary vasoconstriction induced by the thromboxane analogue U46619. Contractility was quantified using the end-systolic pressure-volume and preload recruitable stroke work relationships. The tau-end-systolic pressure relationship was used to assess load-dependency of relaxation. RESULTS: Acute pulmonary hypertension caused a decrease in the slope of the left ventricular preload recruitable stroke work relationship (from 6.64 +/- 1.7 to 5.19 +/- 1.9, mean +/- SD; P < 0.05), a rightward shift of the end-systolic pressure-volume relationship (P < 0.05), and an increase in the slope of the tau-end-systolic pressure relationship (from -0.15 +/- 0.5 to 0.35 +/- 0.17; P < 0.05). The diastolic chamber stiffness constant of both ventricles increased during pulmonary hypertension (P < 0.05). CONCLUSIONS: In the present model, acute pulmonary hypertension impairs left ventricular contractile function and relaxing properties. The present study provides additional evidence that, besides the well-known diastolic ventricular cross talk, systolic ventricular interaction may play a significant role in the haemodynamic consequences of acute pulmonary hypertension.
Authors:
R Amà; H A Leather; P Segers; E Vandermeersch; P F Wouters
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  23     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-06     Completed Date:  2007-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  824-31     Citation Subset:  IM    
Affiliation:
Katholieke Universiteit Leuven, Center for Experimental Surgery and Anesthesiology, Department of Anesthesiology, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Animals
Blood Pressure
Cardiac Output
Disease Models, Animal
Heart Rate
Hypertension, Pulmonary / complications*,  physiopathology*
Myocardial Contraction*
Stroke Volume
Swine
Vascular Resistance*
Ventricular Dysfunction, Left / etiology*,  physiopathology*

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


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