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Biomedical subjects

M L Marcus

Publications and source records attributed to M L Marcus.

At least 199 records · Page 11Linked to original sources

Role of large arteries in regulation of cerebral blood flow in dogs.

Previous studies have demonstrated a significant pressure gradient from carotid artery to pial or middle cerebral arteries. This pressure gradient suggests that large cerebral arteries contribute to cerebral resistance. We have tested the hypothesis that large cerebral arteries contribute to regulation of cerebral blood flow during changes in blood gases and arterial pressure. Microspheres were used to measure brain blood flow in anesthetized dogs. Resistance of large cerebral arteries was estimated by determining the pressure gradient between common carotid and wedged vertebral artery catheters. Systemic hypercapnia and hypoxia dilated large cerebral arteries, and hypocapnia constricted large cerebral arteries. Resistance of large arteries was 0.6+/-0.1 (mean +/- SE) mm Hg per ml/min per 100 g during normocapnia. During hypercapnia and hypoxia, large artery resistance decreased significantly to 0.2 +/- 0.03 and 0.3 +/- 0.05, respectively. During hypocapnia large artery resistance increased significantly to 1.0 +/- 0.1. In other experiments, we found that large cerebral arteries participate in auto-regulatory responses to hemorrhagic hypotension. When arterial pressure was reduced from 110 to 58 mm Hg, autoregulation maintained cerebral blood flow constant, and resistance of large cerebral arteries decreased significantly from 1.0 +/- 0.2 to 0.6 +/- 0.1 mm Hg per ml/min per 100 g. In absolute terms, we calculated that 20-45% of the change in total cerebral resistance during these interventions was accounted for by changes in large artery resistance. These studies indicate that large cerebral arteries, as well as arterioles, participate actively in regulation of cerebral blood flow during changes in arterial blood gases and during autoregulatory responses to hemorrhagic hypotension.

Animals↗

Thallium-201 myocardial perfusion scintigrams in the evaluation of aorto-coronary saphenous bypass surgery.

The effect of aorto-coronary bypass graft surgery (CBG) upon regional myocardial perfusion (RMP) was studied in 23 patients using thallium-201 myocardial perfusing imaging after exercise. We compared the changes in RMP with the clinical status and ECG's during graded treadmill exercise (GTX) before and after CBG. After CBG, the New York Heart Association's "functional class" improved from 3.2 +/- 0.1 (mean +/- SE) to 1.2 +/- 0.2, p less than 0.005. The GTX performance of the patients was also significantly improved postoperatively as judged by the total exercise time (11.7 +/- 0.6 min postop, compared with 7.2 +/- 0.5 min preop; p less than 0.005). Postoperative improved Tl-201 scintigrams were observed in 19 patients, but in only nine patients did the perfusion distribution return to normal. Thus, Tl-201 exercise scintigrams following CBG demonstrate improved RMP in most patients. Failure of regional myocardial perfusion to improve postoperatively, however, does not preclude marked alleviation of angina and improved exercise tolerance.

Adult↗

Demonstration of improved myocardial perfusion following aortic implantation of anomalous left coronary artery.

An adult with anomalous origin of the left coronary artery (originating from the pulmonary artery) had implantation of the anomalous vessel into the aorta. Exercise myocardial perfusion imaging with thallium-201, performed before and after the operation, disclosed a marked improvement in anterior-wall Tl-201 uptake. Postoperative isotope ventriculogram showed improved regional contraction in the revascularized anterolateral wall of the left ventricle. Thus, it has been demonstrated that implantation of an anomalous left coronary into the aorta improves regional myocardial perfusion and regional left-ventricular motion.

Adult↗

Measurement of cerebral blood flow with microspheres.

Labeled microspheres have been used recently to measure cerebral blood flow in experimental animals. The technique allows repeated measurements of regional, as well as total, blood flow to the brain. The microsphere technique has been used to study physiological regulation of cerebral blood flow, and can be used to examine regional cerebral blood flow in experimental models of disease states.

Animals↗

Echocardiography in experimentally-induced myocardial ischemia.

Using an experimental canine model, we have employed echocardiography to study segmental dyskinesis produced by acute coronary occlusion. Characteristic alterations in posterior wall and septal motion occur after acute coronary ligation; these resemble clinical abnormalities described in acute and old myocardial infarction. The degree of dyskinesis produced is directly related to the severity of the perfusion deficit. Coronary reperfusion had variable effects on dyskinesis; most animals showed improvement but in some the myocardial contraction abnormalities became more severe. A vaviety of interventions were undertaken during ischemia. The elevated level of arterial pressure induced by the administration of methoxamine increased ventricular diameter and presumably oxygen requirements, and was deleterious to ischemic wall motion whereas the administration of norpinephrine reduced ventricular diameter and improved function. Intra-aortic balloon counterpulsation had little effect on either ischemic motion or perfusion. These experimental studies generally support conclusions drawn from clinical echocardiograms about the relationship of abnormalities of wall motion to coronary artery lesions and myocardial ischemia, and suggest further clinical uses for echocardiography in coronary disease.

Animals↗

Cardiac size and function in acromegaly.

Sixteen acromegalic patients underwent echocardiography, phonocardiography, stress electrocardiography with Thallium perfusion scanning and gated radioisotope left ventricular angiocardiograms. Abnormalities consisting of increased echo left ventricular mass index, low velocity of circumferential fiber shortening or elevated pre-ejection period to left ventricular ejection time ratio were found in six patients with coexistent hypertension or coronary disease. Concentric left ventricular hypertrophy was also found in three patients with no known etiology other than acromegaly of greater than thirteen years' duration or with fasting growth hormone concentrations greater than 100 ng/ml. One of these three also had left ventricular dysfunction. Neither hypertrophy nor ventricular dysfunction was found in other acromegalics with shorter duration of disease or lower growth hormone concentrations or with normal growth hormone concentrations after therapy. A high prevalence of coronary artery and hypertensive heart disease is associated with acromegaly. A few patients with acromegaly have a specific, potentially reversible cardiomyopathy probably related to prolonged acromegaly or very high growth hormone concentrations.

Acromegaly↗

Distribution of coronary artery flow to the canine right atrium and sinoatrial node.

We assessed segmental distribution of blood flow to the right atrium and the region of the sinoatrial node using micropheres (7-10 mum) in 20 anesthetized dogs. Mean right atrial flow averaged 83+/-7 (SE) ml/min X 100 g, which was 56% of the left ventricular blood flow. The distribution of right atrial flow was not homogeneous. For example, flow to anterior right atriaater (105+/-8 ml/min X 100 g) than mean right atrial flow. Following ligation of the sinus node artery, perfusion of the segment containing the sinus node decreased by only 36%. Relative preservation of perfusion to the sinus node following sinus node artery ligation may explain why ligation of the sinus node artery does not alter heart rate. Furthermore, we also found that cannulation and pump perfusion of the sinus node artery at pressures 10 and 50 mm Hg greater than systolic pressure did not alter the distribution of right atrial flow. Thus, because cannulation and perfusion of the sinus node artery do not artifactually distort regional right atrial blood flow, we conclude that this should be a useful method for evaluating responsiveness of the sinus node to various interventions.

Acetylcholine↗

Effects of intermittent pressure loading on the development of ventricular hypertrophy in the cat.

Although the effects of persistent pressure loading on the development of ventricular hypertrophy have been studied extensively, the effects of intermittent pressure loading have not been examined. To study the effects of intermittent pressure loading we subjected the right ventricle of cats to intermittent pulmonary artery constriction over a 2-week period. Two intermittent pressure loading schedules were employed. The first consisted of a right ventricular systolic pressure of 60 mm Hg for 3.5 days and normal right ventricular pressure for 3.5 days; and the second consisted of a right ventricular systolic pressure of 60 mm Hg for 2.3 days and normal right ventricular pressure for 4.7 days. The intermittent pressure-loaded cats were compared with normal unoperated controls, sham-operated controls, and cats with persistent right ventricular pressure load for either 1-week or 1- to 2-month duration. The data indicate that intermittent pressure loading caused significant right ventricular hypertrophy. Since significant residual ventricular hypertrophy was present in both intermittent pressure loading groups, regression of ventricular hypertrophy involves a slower process than the progression of hypertrophy.

Animals↗

An animal model for experimental echocardiographic studies.

An open-chest canine model for acute experimental echocardiographic studies is described. The ultrasound transducer is placed on the exposed anterior epicardial surface, fixed in place to minimize transmitted motion or excessive pressure on the heart, and directed to record various intracardiac structures. Good recordings can be obtained from the interventricular septum, posterior left ventricular wall, and the mitral and pulmonic valves. Structure identification is facilitated by use of an ultrasound contrast technique. Alterations of normal motion in response to physiologic, pathophysiologic, and pharmacologic interventions can then be assesed. Potential uses of the model are discussed.

Animals↗