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Biomedical subjects

D Franklin

Publications and source records attributed to D Franklin.

At least 109 records · Page 6Linked to original sources
PubMed1976

Analysis of regional myocardial function, dimensions, and wall thickness in the characterization of myocardial ischemia and infarction.

Disorders of contractile function constitute one of the earliest events to follow acute coronary occlusion, and occur in the central ischemic region within approximately 10 seconds. Measurements of regional myocardial dimensions and function in the central, border, and normal zones around an area of ischemia allow assessment of such changes, and when these disorders are persistent after permanent coronary occlusion they may offer an indirect means for assessing the severity and extent of myocardial ischemia and infarction. Recent experimental studies that used pairs of miniature ultrasonic crystals implanted within the subendocardium of open-chested and chronically instrumented, unanesthetized dogs indicate that functional function may be studied simultaneously in these regions; a holosystolic bulge rapidly develops in the central zone of ischemia while hypokinesis is apparent in marginal zones bordering the central region. It has been shown that function in the marginal zone reflects the balance between oxygen supply and demand and may be favorably or unfavorably influenced by acute therapeutic interventions. This finding suggests that the extent of an ischemic region may be altered by such therapy.Our studies further indicate that regional changes in dynamic wall thickness closely parallel the characteristics of shortening of nearby subendocardial segments, indicating that measurement of wall thickness alone may be useful for characterizing regional function. Studies in chronically instrumented animals also have established that the miniature crystals are useful for measuring regional dimensions and function over prolonged periods of time; for example, reduction in end-diastolic dimensions that reflex tissue loss over a 3- to 4-week period after coronary occlusion is substantially greater in the central ischemic regions than in the marginal zones. It is proposed that persistent changes in myocardial function and progressive alterations changes in dimensions over time offer indirect measures of the extent and severity of ischemic damage and infarction. With the development of improved echocardiographic or other clinically applible methods, such measurements may be a useful tool for assessing the effects of therapy on myocardial infarct size.

Acute Disease↗
PubMed1976

Preload, afterload, and the role of afterload mismatch in the descending limb of cardiac function.

Ventricular function can be analyzed from measures of the ejecting phase of contraction (e.g. velocity and extent of wall shortening) in terms of the appropriateness of the matching between afterload and the level of inotropic state, as modulated by the preload. In the normal heart, under controlled conditions an afterload mismatch can be readily induced if the preload is not allowed to compensate for an increased afterload, or if the limit of the Frank--Starling reserve has been reached. In the conscious animal and in man, measures such as the mean velocity of fiber shortening (VCF, corrected for heart size) are relatively constant in the basal state, and when the normal left ventricle adapts successfully over several weeks to sustained experimental volume or pressure overload, the ejection phase measures remain normal per unit of muscle. However, if the inotropic state is considerably reduced, a mismatch between afterload and contractility (reduced VCF) will be evident in the basal state even when the afterload is normal. Failure to maintain normal ejection indices under conditions of acute or chronic mechanical overload can be explained in terms of an excessive afterload relative to the degree of hypertrophy, the level of inotropic state, and the Frank--Starling rereserve. The concept of afterload mismatch is illustrated by experimental data and used as a basis for characterizing responses to afterload changes in the clinical setting.

Animals↗
PubMed1975

[Ultrasound transit-time method for evaluation of regional myocardial function (author's transl)].

The validity of an ultrasound transit-time method for defining local function was evaluated under experimental conditions in the anaesthetized open chest dog. Miniaturized piezoelectric crystals (1,5-2 mm phi) functioning as emitters and receivers were inserted into different depths of the myocardium to study the contraction patterns of defined muscle segments in different muscle layers and the dynamic changes of left ventricular wall thickness during the heart cycle. Changes in myocardial function were induced by coronary stenosis or occlusion and by the application of drugs. This method was shown to be a sensible and reliable tool for the evaluation of local myocardial function.

Animals↗
PubMed1975

Effects of an inotropic agent, RO 2-2985 (X-537A), on regional blood flow and myocardial function in chronically instrumented conscious dogs and anesthetized dogs.

RO 2-2985 produced a marked positive inotropic effect in unanesthetized, chronically instrumented dogs, measured as an increase in left ventricular dP/ dt and an increase in maximum velocity of myocardial fiber shortening. Similar changes produced in dogs in hemorrhagic shock lasted for 2-3 hours. RO 2-2985 increased peripheral blood flow and caused marked increases in both coronary and renal blood flows. The drug altered the response of the renal vascular bed to subsequent norepinephrine administration. After administration of a single dose of RO 2-2985, norepinephrine produced sustained increases in renal blood flow, and this altered responsiveness to norepinephrine persisted for periods ranging from 1 to 3 weeks.

Anesthesia↗
PubMed1973

Extent of regulation of the heart's contractile state in the conscious dog by alteration in the frequency of contraction.

The effects of alterations in the frequency of contraction over the range from 94 to 220/min on left ventricular pressure, diameter, and dP/dt were studied in 10 dogs instrumented with ultrasonic diameter ganges and miniature pressure gauges. The same dogs were studied on separate days in the conscious state, after general anesthesia with pentobarbital Na, 30 mg/kg, and in the conscious state after pretreatment with propranolol, 3 mg/kg. End diastolic diameter was maintained constant during alterations in frequency by infusing saline intravenously. The maximum increases in peak dP/dt and dP/dt/P in the conscious state were 14 and 10%, respectively. After anesthesia, raising the frequency of contraction from 122 to 220/min caused maximum increases in peak dP/dt and dP/dt/P of 36 and 30%, respectively. In the conscious state after cardiac depression by propranolol, the maximum increases in peak dP/dt and dP/dt/P were 23 and 23%, respectively. Thus, increasing the frequency of contraction of the normal heart of the conscious dog causes only a slight inotropic effect, but this effect is significantly greater in the presence of myocardial depression produced by anesthesia with pentobarbital Na or in the conscious animal after a myocardial-depressing dose of propranolol.

Anesthesia, General↗