[Basic factors determining myocardial performance].
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Biomedical subjects
Publications and source records attributed to J Juchmès.
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The dopamine alpha- and beta-adrenoceptor dose-response curves are investigated in four patients who are exempt from cardiovascular disease. A dose-related increase in CO, HR and SV is observed with infusion rates of up to 3 micrograms kg-1 min-1. With concentrations greater than 10 micrograms kg-1 min-1, both BP and SVR increase. Low-dose dopamine infusion less than 3 micrograms kg-1 min-1 is investigated in ten other patients. With this infusion rate, a selective renal vasodilation is induced without peripheral or cardiac beta-adrenoceptor activation. Dopamine is responsible for an increase in diuresis FENa, GFR and RBF. These properties are indicated in renal failure, and when haemodynamic support is required in cardiac failure, if an infusion rate of up to 10 micrograms kg-1 min-1 is able to reverse cardiac insufficiency.
The energy equivalent of plasma lactate production (ELAp) represents the amount of energy that can be derived from the anaerobic glycolysis per kg body weight when the peak plasma lactate concentration (LAp) after exercise increases by 1 mM. ELAp has been calculated from the relationship between the oxygen deficit (Do2) and LAp in 32 subjects. LAp and oxygen uptake measurements were made during constant speed supramaximal running until exhaustion or during the course of constant-speed supramaximal runs of different duration interrupted by 8- to 10- min resting periods. The relationship between Do2 and LAp is described by a linear equation where the slope is equal to ELAp. This equation is: Do2 = 12.3 + 2.4 LAp (r = 0.958; P less than 0.001), where Do2 is expressed in ml O2/kg and LAp in mmol/litre (mM). These findings validate LAp measurements as an index of the anaerobic metabolism during supramaximal running.
In anaesthetized dogs, low dose endotoxin perfusion (250 ng kg-1 min-1 during 20 min) resulted, after a delay of 15-40 min, in a decrease of mean arterial pressure (from 127 to 106 mm Hg), a transient increase in cardiac output (from 2.2 to 2.9 L/min), a fall of systemic vascular resistance (from 60 to 41 mm Hg L-1 min-1) and an increase in heart rate (from 109 to 156/min). This haemodynamic pattern is similar to the so called "hyperdynamic" initial phase of clinical septic shock.
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1. -- In young well trained adults, adrenergic beta receptors blockade by pindolol or propranolol causes a relative bradycardia during running on a threadmill during 10 to 20 min at 50% VO2 max. 2. -- Pindolol activity is maximum for 5-7.5 mg ingested one hour before starting. In two subjects, tachycardia reappears for 30 mg : this secondary increase may be explained by an intrinsic sympathetic activity of pindolol. 3. -- Propranolol is about 14 times less active than pindolol without any intrinsic sympathetic activity.
In ageing female subjects, the urinary noradrenaline excretion (UNA) is reduced with respect to the controls in young adults. On the other hand the ratio UNA/clearance of endogenous creatinine increases with ageing. This provides a confirmation of the fact that ageing is associated with an increase in plasma noradrenaline. The ratio UA/clearance of creatinine remains unaltered. So far the physiological meaning of these results remains unclear.
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