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Biomedical subjects

R D Latham

Publications and source records attributed to R D Latham.

At least 37 records · Page 2Linked to original sources
PubMed1990

Isolated aorta setup for hemodynamic studies.

A setup consisting of a high-performance hydraulic pump connected to the ascending part of an isolated aorta, including all major distal branches, each loaded with calibrated artificial resistors, was developed. The system was used to study total aortic compliance of the baboon as a function of mean aortic pressure (n = 5). The aorta loaded with the resistors was mounted in a custom-designed sink table, such that it was submersed in physiological saline maintained at 37 degrees C. Mean distending pressure in the entire aorta could be varied. The three-element Windkessel model was used to estimate total aortic compliance from pressure and flow waves generated by the pump. Total aortic compliance as a function of mean pressure was fitted with a logarithmic function: Ln(Compliance) = A + B * P. The value of A (+/- SE) was: 1.565 +/- 0.319 and B: -0.020 +/- 0.003 (P less than 0.001). The results were compared with previously published results (also using the same three-element Windkessel fit) obtained in three of the same animals in vivo. The in vivo data were A: 1.095 +/- 0.235 and B: B: -0.019 +/- 0.003. In vitro data had a significantly higher value of A than in vivo (P = 0.017), implying a significantly higher aortic compliance in vitro than in vivo. Occlusion of the proximal descending aorta was performed at a low distending pressure (55 mm Hg) to determine the proximal compliance. It was found (n = 4) that 46 +/- 11% (SD) of the total arterial compliance is to be attributed to the ascending and proximal descending aorta.

Animals↗
PubMed1990

Pulmonary arterial compliance at rest and exercise in normal humans.

We evaluated the feasibility of determining pulmonary arterial compliance (Cp) by a parameter estimation procedure based on the three-element windkessel model. Eight normal patients studied with multisensor micromanometry technology had simultaneous rest and exercise pulmonary artery pressures (PAP) and flows recorded. These were submitted to the model and independent methods to determine Cp, pulmonary characteristic impedance (Zc), and pulmonary vascular resistance (PVR). Significant changes in heart rate, PAP, and stroke volume (P less than 0.05) occurred with exercise. In comparing rest and exercise Zc and PVR values determined by the model and independent methods, and in comparing each method for these values, there was no significant difference. Model-derived and independently derived estimates of Cp were significantly different at rest (P less than 0.04) and exercise (P less than 0.001). There was no significant difference between rest and exercise values of Cp by either method. The model estimates of PVR at rest (64 +/- 11 dyn.s.cm-5) and exercise (41 +/- 7 dyn.s.cm-5) (P = 0.06) and the model Zc value at rest (22 +/- 3 dyn.s.cm5) were appropriate. The model Cp values at rest (0.22 +/- 0.05 ml.mmHg-1.kg-1) correlated with previously reported normalized values in other species. This study reports the successful use of a parameter estimation procedure based on the three-element windkessel model to describe pulmonary artery compliance in normal humans.

Adult↗
PubMed1989

Recently diagnosed idiopathic dilated cardiomyopathy: incidence of myocarditis and efficacy of prednisone therapy.

Fifty-two patients with recently diagnosed idiopathic dilated cardiomyopathy were studied to determine the incidence of myocarditis; patients were randomly assigned to receive either conventional therapy alone or conventional therapy plus prednisone to assess possible therapeutic efficacy with regard to survival. Inflammatory criteria were present in 23% of the population studied with 13% having overt myocarditis according to the Dallas criteria. The addition of prednisone to conventional therapy did not improve survival in a homogeneous population with new-onset dilated cardiomyopathy. Furthermore, the diagnosis of myocarditis by endomyocardial biopsy did not influence 2-year survival once dilated cardiomyopathy had developed. Biopsy-documented myocarditis resolved in all patients, according to results of 3-month follow-up endomyocardial biopsies, regardless of treatment group. There was a trend for patients with a left ventricular ejection fraction less than 20% to show reduced survival at 2 years compared to the group with a higher ejection fraction (p = 0.07). Right ventricular dysfunction determined at catheterization was present in 20 of 52 patients and was the most significant predictor of survival. Patients with preserved right ventricular function had a 95% 24-month survival rate compared to 47% for patients with right ventricular diastolic dysfunction (right ventricular end-diastolic pressure greater than or equal to 11 mm Hg) (p = 0.005).

Adult↗
PubMed1988

Aortic input impedance during Mueller maneuver: an evaluation of "effective length".

Aortic input impedance was calculated in seven subjects in the control state (normal reflection) and during the Mueller maneuver (increased reflection) to evaluate "effective arterial length" under altered physiological conditions. Regional foot-to-foot pulse wave velocities and pressure waveforms along the aorta were used to define an "apparent anatomic length" or distance to a dominant discrete site of reflection "seen" by the ejecting ventricle. Time of wave travel was taken to be one-half the interval from the foot of the incident wave to the midsystolic inflection point. Knowing the time of travel from the returning reflection and velocity, distances calculated to the "apparent anatomic length" were 35 +/- 2 and 34 +/- 2 during control and Mueller maneuver, respectively (P = NS). The frequency of the first minimum of the modulus (fmin) and the first zero crossing of the phase angle (f phi) were determined from the input impedance spectra. During baseline conditions, fmin (3.9 +/- 0.2 Hz) approximately equaled f phi (4.2 +/- 0.2 Hz), and the resulting "effective lengths" calculated using the quarter-wavelength formula were similar to the apparent anatomic length. These data suggested that the aortic region incorporating the renal arterial branches as a site of discrete reflection and that terminal load was not significantly frequency dependent. During Mueller maneuver, however, f min (3.3 +/- 0.2 Hz) and f phi (5.1 +/- 0.2 Hz) were significantly discordant, the terminal load became strongly frequency dependent, and effective length calculated from f min was dissimilar (P less than 0.05) from the unchanged apparent anatomic length.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Ventricular/vascular coupling and regional arterial dynamics in the chronically hypertensive baboon: correlation with cardiovascular structural adaptation.

Ventricular/vascular coupling dynamics and regional hemodynamics of five hypertensive baboons with concentric left ventricular (LV) hypertrophy (mean arterial pressure +/- SD, 148 +/- 16 mm Hg; LV mass/body weight ratio 3.42 +/- 0.8) were compared with five normotensive controls (mean arterial pressure 89 +/- 3 mm Hg; LV mass/body wt ratio 2.73 +/- 0.5) at different mean arterial pressures. Ventricular/vascular dynamics were assessed by aortic input impedance, pulsatile/total power ratio, effective arterial elastance and compliance from a three-element Windkessel "lumped" model of the circulation. Regional arterial dynamics were assessed by pulse-wave velocities and local reflection coefficients. Systemic arterial compliance was similarly decreased with elevated pressure in both groups but was significantly more reduced for the hypertensive group compared with control animals at control (0.49 +/- 0.16 vs. 0.96 +/- 0.09 ml/mm Hg; p less than 0.05) and acutely lowered arterial pressure (0.62 +/- 0.26 vs. 1.41 +/- 0.24 ml/mm Hg, respectively). Changes in compliance were paralleled by differences in effective arterial elastance derived from cineventriculographic pressure-volume ratios. Regional foot-foot and apparent phase pulse-wave velocities were significantly increased for distal aortic segments of the hypertensive animals during elevated pressures compared with controls (cff, 17.5 +/- 7.5 vs. 8.7 +/- 3.0 m/sec; p less than 0.05). Histology of the aorta revealed significant increases in collagen content (microgram/mg dry wt) from proximal to distal aortic segments (27 +/- 2 vs. 38 +/- 6; p less than 0.005) in hypertensive animals but not in controls (27 +/- 2 vs. 32 +/- 6; NS). With pharmacological normalization of systemic arterial pressures, hypertensive baboons developed aortic wave speeds similar to controls but manifested significantly reduced compliance compared with controls. In contrast, with acute elevations of pressure, systemic arterial aortic compliances were similar for both groups, but distal pulse-wave velocities were significantly increased for hypertensive animals compared with controls. We conclude that measures of ventricular/vascular coupling and arterial dynamics are determined by both the level of arterial pressure and the physical characteristics of the cardiovascular system in chronic systemic hypertension and pressure overload ventricular hypertrophy.

Adaptation, Physiological↗
PubMed1987

Cardiovascular reserve in idiopathic dilated cardiomyopathy as determined by exercise response during cardiac catheterization.

Simultaneous right- and left-sided cardiac high-fidelity hemodynamic measurements were obtained at rest and supine exercise during cardiac catheterization in 27 patients (mean age 32 +/- 10 years) with idiopathic dilated cardiomyopathy to investigate the hemodynamic exercise response and possible mechanisms for the wide variation in exercise tolerance observed clinically. There were no significant differences in other rest hemodynamic variables between group 1, patients with a normal exercise factor (more than 600, n = 10), and group 2, patients with an abnormal exercise factor (less than 600, n = 17). A greater increase in stoke volume index (12 +/- 6 vs 2 +/- 8 ml/beats/m2, mean +/- standard deviation) and a greater decrease in systemic vascular resistance with exercise occurred in group 1 than in group 2 (-614 +/- 304 vs -406 +/- 291 dynes cm-5). Elevation of right ventricular end-diastolic pressure with exercise was significantly greater in group 2 than in group 1 (7 +/- 5 vs 1 +/- 4 mm Hg, respectively, p less than 0.05). A maintained cardiac reserve in patients with idiopathic dilated cardiomyopathy appears to be largely dependent on 2 primary factors: preservation of normal right ventricular function during exercise; and preservation of systemic vasodilator capability sufficient to produce a significant degree of afterload reduction during exercise.

Adolescent↗
PubMed1987

Nonhuman primate model for regional wave travel and reflections along aortas.

Arterial pulse transmission and wave reflections were studied in five mature anesthetized baboons (Papio anubis) using multisensor micromanometry. Simultaneous pressures were recorded from the left ventricle and every 10 cm along the aorta and its terminal branches, and flow velocity was measured in the aortic root. Aortic input impedance and regional foot-to-foot and apparent phase velocities were calculated. Aortography provided dimensional data for local reflection coefficients. Regional foot-to-foot wave speeds were somewhat lower than corresponding segments in humans. Proximal aortic pressure waveforms and characteristic impedance (110 +/- 29 dyn X s X cm-5) were not characteristic of middle-aged humans. Reflection coefficients at the terminal aortic bifurcation (0.06) at the level of the renal artery branches (0.09) were less than those found in humans. We conclude that the junction of the renal artery branches and the aorta in the baboon is closely matched and represents much less of a discrete reflection site than in humans. Although the baboon may be used to study pulse transmission characteristics in the baboon, this species is not a good model for the proximal systemic reflective characteristics of normal middle-aged humans.

Animals↗
PubMed1987

Hemodynamics of the Mueller maneuver in man: right and left heart micromanometry and Doppler echocardiography.

Ten subjects with normal hemodynamics were studied during elective cardiac catheterization with right and left heart multisensor micromanometry to assess hemodynamic responses to the Mueller maneuver. Simultaneous right and left circulatory hemodynamics and left ventricular, pulmonary arterial, and aortic pressures were recorded, in addition to pulmonary arterial and aortic flow velocities. Steady-state cardiac outputs were determined by thermal dilution. Aortic systolic and mean pressures were not significantly changed during the Mueller maneuver, in contrast to a lower diastolic (p = .019) and higher pulse pressure (p = .016). Mean right atrial pressure (+/- SE) decreased from 7 +/- 1 to -17 +/- 4 mm Hg (p = .0002) and the right atrial "x" descent was markedly accentuated. Left ventricular end-diastolic pressure decreased from 12 +/- 4 to -3 +/- 13 mm Hg (p = .0025). Systemic vascular resistance and left ventricular peak positive dP/dt were increased during the Mueller maneuver (p less than .02), cardiac output and stroke volume were reduced (p less than .05), and there was no significant change in heart rate. Right and left peak flow velocities showed a trend toward a bilateral decrease (right, p = .054; left, p greater than .1), and times to peak flow velocity were increased in the pulmonary artery (p = .007) and reduced in the aortic root (p = .03). Normal subjects were studied separately by pulsed Doppler echocardiography. During the sustained Mueller maneuver, the internal jugular and right ventricular dimensions decreased, and superior vena cava Doppler flow was reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Regional wave travel and reflections along the human aorta: a study with six simultaneous micromanometric pressures.

The human aorta and its terminal branches were investigated in normal subjects during elective cardiac catheterization to evaluate regional wave travel and arterial wave reflections. A specially designed catheter with six micromanometers equally spaced at 10 cm intervals was positioned with the tip sensor in the distal external iliac artery and the proximal sensor in the aortic arch. Simultaneous pressures were obtained and analyzed for foot-to-foot wave velocity, and Fourier analysis was used to derive apparent phase velocity. These quantities were assessed during control (n = 9), during Valsalva (n = 8) and Müller (n = 4) maneuvers, and during femoral artery occlusion by bilateral manual compression (n = 8). During control, regional cross-sectional areas, determined from aortography, and regional foot-to-foot pulse wave velocities were used to calculate the local reflection coefficient in the proximal descending aorta (gamma = 0.05), at the junction of the renal arteries (gamma = 0.43), and at the terminal aortic bifurcation (gamma = 0.13). To test the hypothesis that significant reflections originate in the aorta, at the level of the renal arteries, aortograms were used to design a latex tube model with geometric properties similar to the descending aorta. Velocities and reflection characteristics in the model and in vivo were compared. Inspection of thoracic aortic pressures under control conditions revealed a reflected wave originating from the region of the aorta at the level of the renal arterial branches while abdominal pressures exhibited reflection from a site peripheral to the terminal aortic bifurcation. In the low frequency range, apparent phase velocity was found to be higher proximal to the renal arteries as compared with at the distal sites. In addition, the minimum value occurred at a higher frequency in the lower thoracic aorta than at more distal sites. The effects of reflection on apparent wave velocity in the tube model were consistent with data obtained in vivo. The Valsalva maneuver diminished the reflection from the aortic region of the renal arteries, thus allowing the distal reflected wave to become more evident on the thoracic pressure waveforms. Bilateral femoral artery occlusion usually enhanced the distal reflection and the Müller maneuver usually resulted in small increases in reflections. In conclusion, the geometric and elastic nonuniformity of the aorta results in two major sites of arterial wave reflection that influence the aortic pressure waveforms in man.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1984

Acute poststreptococcal glomerulonephritis progressing to rapidly progressive glomerulonephritis.

We have reported a rare, well documented case of poststreptococcal glomerulonephritis followed by rapidly progressive glomerulonephritis after weeks of stable renal function. The patient was successfully treated with steroids, azathioprine, and plasmapheresis. Progression of stable proliferative poststreptococcal glomerulonephritis to rapidly progressive glomerulonephritis appears to be uncommon.

Acute Disease↗
PubMedDate not supplied

Effects of 12 days exposure to simulated microgravity on central circulatory hemodynamics in the rhesus monkey.

Central circulatory hemodynamic responses were measured before and during the initial 9 days of a 12-day 10 degrees head-down tilt (HDT) in 4 flight-sized juvenile rhesus monkeys who were surgically instrumented with a variety of intrathoracic catheters and blood flow sensors to assess the effects of simulated microgravity on central circulatory hemodynamics. Each subject underwent measurements of aortic and left ventricular pressures, and aortic flow before and during HDT as well as during a passive head-up postural test before and after HDT. Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure were measured, and dP/dt and left ventricular elastance was calculated from hemodynamic measurements. The postural test consisted of 5 min of supine baseline control followed by 5 minutes of 90 degrees upright tilt (HUT). Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure showed no consistent alterations during HDT. Left ventricular elastance was reduced in all animals throughout HDT, indicating that cardiac compliance was increased. HDT did not consistently alter left ventricular +dP/dt, indicating no change in cardiac contractility. Heart rate during the post-HDT HUT postural test was elevated compared to pre-HDT while post-HDT cardiac output was decreased by 52% as a result of a 54% reduction in stroke volume throughout HUT. Results from this study using an instrumented rhesus monkey suggest that exposure to microgravity may increase ventricular compliance without alternating cardiac contractility. Our project supported the notion that an invasively-instrumented animal model should be viable for use in spaceflight cardiovascular experiments to assess potential changes in myocardial function and cardiac compliance.

Aerospace Medicine↗