Document Detail


Power-afterload relation in the failing human ventricle.
MedLine Citation:
PMID:  1537089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Animal studies have shown that the power output of the left ventricle is related to afterload by a bell-shaped curve. Furthermore, the normal ventricle operates at the maximum power point, whereas the diseased ventricle operates off the maximum power point because of increased afterload. We studied this relation in eight patients with dilated cardiomyopathy. A high-fidelity catheter with micromanometer pressure and electromagnetic velocity transducers was used to measure blood pressure and flow velocity in the ascending aorta. The latter was converted into volumetric flow by calibrating with the simultaneously determined thermodilution cardiac output. Ventricular power was calculated by dividing the integral of the aortic blood pressure-flow product by the duration of the cardiac cycle. Intravenous nitroprusside was used to alter afterload and the power-afterload relation was obtained by plotting power against mean aortic blood pressure. In all patients, as blood pressure was lowered initially, the power output of the left ventricle increased. As the dose of nitroprusside was increased further, the total power either plateaued or actually decreased. The averaged power and the mean blood pressure at control were 1.00 +/- 0.62 W and 92 +/- 9.3 mm Hg, respectively. The averaged maximum increase in power with nitroprusside was 22%, to 1.22 +/- 0.73 W, and this occurred at a mean pressure of 80 +/- 8.8 mm Hg. This study showed that the power-afterload relation in the human ventricle has a maximum power point at some intermediate level of afterload, similar to that found in animal studies.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
Y C Chiu; P W Arand; J D Carroll
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation research     Volume:  70     ISSN:  0009-7330     ISO Abbreviation:  Circ. Res.     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-03-27     Completed Date:  1992-03-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0047103     Medline TA:  Circ Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  530-5     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Chicago, Illinois.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Flow Velocity
Cardiomyopathy, Dilated / physiopathology*
Dose-Response Relationship, Drug
Female
Heart Catheterization
Heart Function Tests
Hemodynamics / drug effects
Humans
Male
Middle Aged
Nitroprusside / administration & dosage
Ventricular Function, Left / drug effects,  physiology*
Chemical
Reg. No./Substance:
15078-28-1/Nitroprusside

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


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