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Biomedical subjects

W C Hunter

Publications and source records attributed to W C Hunter.

At least 37 records · Page 2Linked to original sources
PubMed1992

Effects of calcium and EMD-53998 on oxygen consumption in isolated canine hearts.

BACKGROUND: Most positive inotropic agents increase cardiac contractility by increasing the amount of Ca2+ cycled with each beat. The additional amount of oxygen that is consumed by the heart to cycle this additional Ca2+ is believed to reduce myocardial efficiency. On the other hand, it has been suggested that the agent EMD-53998 increases the Ca2+ sensitivity of the contractile proteins without affecting the intracellular Ca2+ transient in cardiac muscle. Therefore, application of this agent may increase cardiac contractility without decreasing myocardial efficiency. The purpose of the present study was to test this hypothesis. METHODS AND RESULTS: We measured myocardial oxygen consumption (MVO2) in six isolated, isovolumically beating blood-perfused canine hearts. The hearts were paced at 120 beats per minute. Contractility was varied in each heart by infusion of either CaCl2 or EMD-53998. With infusion of either agent, MVO2 was a linearly proportional function of contractility. No significant difference between CaCl2 and EMD-53998 could be detected in the interrelation between contractility and MVO2. CONCLUSIONS: We conclude that the "calcium-sensitizing agent" EMD-53998 is a potent positive inotropic agent in the isolated, blood-perfused canine heart. However, EMD-53998 does not provide an energetic advantage over currently used positive inotropic agents.

Animals↗
PubMed1992

Alterations in left ventricular mechanics, energetics, and contractile reserve in experimental heart failure.

The contributions of changes in primary systolic and diastolic properties, limitations of contractile reserve, and alterations in energy efficiency to the left ventricular dysfunction seen with chronic pacing tachycardia were investigated. Seven dogs (heart failure group) were ventricularly paced at 250 beats per minute for 26.3 +/- 2.9 days and compared with a separate control group (n = 8). STudies were performed with isolated, metabolically supported hearts coupled to a computer-controlled loading system. Pressure-volume relations and myocardial oxygen consumption (MVO2) were measured to assess chamber systolic and diastolic properties and efficiency (relation between MVO2 and pressure-volume area [PVA]). Systolic function was reduced in failure hearts versus controls as assessed by the slope of the end-systolic pressure-volume relation (1.29 +/- 0.94 versus 2.71 +/- 0.98 mm Hg/ml, p less than 0.01) and lowered end-systolic stiffness at a matched stress (956.1 +/- 123.5 versus 1,401.7 +/- 431.7 g/cm2, p less than 0.05). Diastolic chamber and myocardial stiffness were unaltered in failure hearts, but the unstressed diastolic-arrested volume was significantly larger (33.3 +/- 3.9 versus 21.9 +/- 7.6 ml, p less than 0.01). Inotropic response to increased heart rate and exogenous beta-adrenergic stimulation (dobutamine HCl) was significantly impaired in failure compared with control hearts. Most interestingly, failure hearts had a lowered slope of the MVO2-PVA relation (2.1 +/- 1.1 versus 2.9 +/- 1.4 ml O2.mm Hg-1.ml-1.100 g left ventricle-1, p less than 0.001), indicating increased efficiency of chemomechanical energy conversion. The y intercept of the MVO2-PVA relation, which reflects oxygen costs of basal metabolism and excitation-contraction coupling, was unchanged in the two groups despite decreased contractility of the heart failure hearts. These results demonstrate reduced chamber and myocardial contractility, dilatation without alteration of passive myocardial properties, impaired contractile reserve, and novel alterations in cardiac efficiency in this model of heart failure.

Animals↗
PubMed1992

Basal metabolism adds a significant offset to unloaded myocardial oxygen consumption per minute.

Myocardial oxygen consumption (MVO2) includes components for 1) mechanical energy generation, 2) activation, and 3) basal metabolism. Whereas the first two components are expected to increase in proportion with heart rate, a significant basal level of metabolism would consume oxygen even if the heart rate were zero. Contrary to this expectation, however, a previous study reported that, during unloaded beats, MVO2 per beat (which includes basal metabolism) was independent of heart rate. Accordingly, unloaded MVO2 per minute would extrapolate to zero at zero heart rate; this result is unexpected considering basal metabolism. To resolve this inconsistency, we varied heart rate over a wide range after inducing atrioventricular block in eight isolated cross-circulated canine hearts that contracted isovolumically. We examined whether a term representing rate-independent basal metabolism was needed to describe MVO2 per minute. Mechanical energy generated by the left ventricle was evaluated from the pressure-volume area, which was altered by changing isovolumic ventricular volume over at least five levels at each heart rate. Contractility, evaluated by the slope of the end-systolic pressure-volume relation, did not vary significantly with heart rate in this study. In contrast to the previous report, unloaded MVO2 per beat (i.e., MVO2 extrapolated to a pressure-volume area of zero) was not constant but fell monotonically with increases in heart rate in every heart. We considered that this trend was caused by a significant rate-independent basal level of MVO2 per minute. Multiple linear regression analysis confirmed that this rate-independent basal term differed significantly from zero in seven of the eight hearts studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Contractile strength and mechanical efficiency of left ventricle are enhanced by physiological afterload.

Recent studies have shown that at the same endsystolic volume, ejecting beats can achieve a higher end-systolic pressure than isovolumic beats. The purpose of this study was to assess the metabolic cost, in terms of oxygen consumption (MVO2), and efficiency, in terms of the relation between MVO2 and pressure-volume area (PVA), of this increase in strength during ejection. The slope of the end-systolic pressure-volume relation (ESPVR) (Ees) was greater during ejecting than isovolumic contractions when ejection fraction (EF) was greater than approximately 30%, indicating an increase in contractile strength. The difference in Ees between the two modes of contraction was as much as 30% at EFs of 60%. In contrast, the slope of the MVO2-PVA relation was less during ejecting than isovolumic contractions, indicating a decrease in MVO2 at any given PVA. The difference in slope was as much as 20% at EFs of 60%. Thus afterload conditions, allowing substantial fiber shortening, shift the ESPVR toward greater contractile strength and increase the metabolic efficiency when viewed in terms of the relation between MVO2 and total mechanical energy generation (PVA) by the ventricle. This may reflect an energetically favorable effect of shortening on muscle force-generating capability.

Animals↗
PubMed1991

Estimated time course of Ca2+ bound to troponin C during relaxation in isolated cardiac muscle.

We present a mechanical assay for estimating the time course of Ca2+ bound to low-affinity sites on troponin C (TnC) in twitching rabbit papillary muscle. The assay is based on a theoretical correlation between the rate of force redevelopment after detachment of all cross-bridges and the amount of Ca2+ bound to TnC. Experimentally, we applied length impulses at different times to detach all cross-bridges; the initial rate of force redevelopment after each impulse was taken as an index of bound Ca2+ at that time. Under control conditions, the magnitude of this index decreased to 10% of its maximum during early relaxation, when force had declined only slightly 78 +/- 12% of its peak isometric value. The time course of this index was examined after addition of either isoproterenol or ryanodine, which are known to shorten and prolong, respectively, the intracellular free Ca2+ transient. As expected, changes previously reported in the free Ca2+ time course were qualitatively reflected in the time course of the bound Ca2+ index. We conclude that this index constitutes a reasonable method for estimating the time course of bound Ca2+ and that bound Ca2+ declines well ahead of force in isometrically contracting rabbit myocardium at 24 degrees C.

Animals↗
PubMed1991

Dynamic properties of left ventricular response to changes in coronary perfusion.

To determine the dynamic property of cardiac function response to alterations in coronary perfusion, we varied coronary arterial pressure (CAP) sinusoidally around one of four mean CAP levels with a constant amplitude at several frequencies in isolated, isovolumically contracting canine heart preparations. From the frequency spectrum of the peak left ventricular pressure (PLVP) response, we arrived at a phenomenological model with two components coupled in parallel and estimated the parameter values. One component is a first-order delay system having a short time constant (approximately 1 s) and a small gain (range 0.08-0.16); it probably represents a hydraulic effect of coronary perfusion. The other component is a second-order delay system with longer time constants (approximately 15 and 6 s) and a larger gain (range 0.14-0.69); this probably represents a metabolic effect. The gain value of the slow component varied inversely with the mean CAP level, and studies with adenosine suggested that this dependence was due to the coronary autoregulation. The model prediction of the transient responses of PLVP to step changes in CAP agreed reasonably well with those experimental data of transient responses obtained in the identical hearts but not used to determine the model parameter values.

Adenosine↗
PubMed1991

Unique strain history during ejection in canine left ventricle.

Understanding the relationship between structure and function in the heart requires a knowledge of the connection between the local behavior of the myocardium (e.g., shortening) and the pumping action of the left ventricle. We asked the question, how do changes in preload and afterload affect the relationship between local myocardial deformation and ventricular volume? To study this, a set of small radiopaque beads was implanted in approximately 1 cm3 of the isolated canine heart left ventricular free wall. Using biplane cineradiography, we tracked the motion of these markers through various cardiac cycles (controlling pre- and afterload) using the relative motion of six markers to quantify the local three dimensional Lagrangian strain. Two different reference states (used to define the strains) were considered. First, we used the configuration of the heart at end diastole for that particular cardiac cycle to define the individual strains (which gave the local "shortening fraction") and the ejection fraction. Second, we used a single reference state for all cardiac cycles i.e., the end-diastolic state at maximum volume, to define absolute strains (which gave local fractional length) and the volume fraction. The individual strain versus ejection fraction trajectories were dependent on preload and afterload. For any one heart, however, each component of absolute strain was more tightly correlated to volume fraction. Around each linear regression, the individual measurements of absolute strain scattered with standard errors that averaged less than 7% of their range. Thus the canine hearts examined had a preferred kinematic (shape) history during ejection, different from the kinematics of filling and independent or pre-or afterload and of stroke volume.

Animals↗
PubMed1990

Inhomogeneous deformation as a source of error in strain measurements derived from implanted markers in the canine left ventricle.

This article quantifies the errors inherent in the measurement of myocardial strain in the canine left ventricle when the motion of four radiopaque marker beads is used to determine this strain. These errors are introduced because the strain is strongly inhomogeneous and only an averaged value of this strain can be determined by measuring the displacements of four points with finite separation. In this work, the error in the principal strains has been estimated by modeling the primary deformation components of the left ventricle and comparing the true strains obtained from these models with the strains computed according to the protocol typically used in experimental studies to determine strain from the motion of marker beads. Both a cylindrical and a spherical model of the left ventricle are used. For the cylindrical model, it is found that the traditional tetrahedra used may give errors as high as 20% in the maximum principal strain. A six-marker prism is found to give more consistent results, underestimating the maximum principal strain, which is in the radial direction, by no more than 8% in almost all cases. The spherical model, having double curvature, gives larger errors. In both models, the error in the other two principal strains was usually less than 5%. Furthermore, the principal strain directions were correct to within 6 degrees.

Animals↗
PubMed1990

Metabolic and functional consequences of barium-induced contracture in rabbit myocardium.

Barium contracture tonically activates myocardium while preserving cellular integrity. We studied the metabolic and mechanical consequences of sustained Ba2+ contracture. We measured the time course of phosphocreatine (PCr), ATP, Pi, total phosphate, and intracellular pH via 31P nuclear magnetic resonance (NMR) in isolated, isovolumic rabbit hearts. For mechanical studies, we measured force transients and dynamic stiffness in excised rabbit right ventricular papillary muscles at different elapsed times in Ba2+ contracture. In the perfused hearts, PCr fell steadily to 20% of control after 60 min. ATP remained constant for approximately 25 min then fell to 25% by 60 min. Pi rose to 200% within 15 min and then remained unchanged, whereas total phosphate dropped steadily to 50% of control by 60 min. Myocardial O2 consumption remained near control for 30 min and then declined to 50% by 60 min. Consistent with ATP and O2 consumption measurements, mechanical responses were unchanged for approximately the first half hour. Because of the elevated Pi, however, myofilament kinetics may have been accelerated compared with the control metabolic state. After the initial period of stable contracture, the gradual alteration of mechanical behavior exhibited a progressive trend toward more rigor-like characteristics. In summary, myocardium in Ba2+ contracture is metabolically and mechanically stable for approximately 30 min but begins to degrade thereafter. When compared with other tonic states of activation, Ba2+ contracture appears to be less demanding energetically.

Animals↗
PubMed1990

Esophageal contribution to chest pain in patients with coronary artery disease.

We conducted a prospective study to determine the role of the esophagus in causing chest pain in patients with established CAD on optimum therapy. Thirty-two men with documented CAD who complained of frequent and usually daily retrosternal chest pain were evaluated. Following a standard esophageal manometry and acid perfusion test, simultaneous two-channel ambulatory Holter monitor and esophageal pH record tests were performed for 24 hours. Fifty-three episodes of chest pain were documented in 20 patients; 11 patients were free of pain. Of the 20 patients who complained of chest pains, 17 (85 percent) demonstrated at least one episode of PPR, defined as a drop in distal esophageal pH to less than 4 within ten minutes before or after the onset chest pain. Episodes of asymptomatic GER were common. The correlation of PPR with chest pain was 70 percent (37/53 episodes) and of ischemic ECG changes with chest pain 13 percent (7/53); in the remaining, there was no correlation with either. Two patients demonstrated simultaneous PPR and ischemic ECG changes. Seventeen esophageal motility abnormalities were observed in 14 patients (45 percent). It is our conclusion that esophageal disorders contribute to chest pain in patients with documented CAD. In this group, GER plays a greater role than in those with normal coronary arteries. In addition, esophageal motility disorders are common in these patients. Esophageal testing can be undertaken safely in these patients.

Aged↗
PubMed1989

Control of segment length or force in isolated papillary muscle: an adaptive approach.

Mechanical studies of isolated cardiac muscle are complicated as a result of damage inflicted on the ends of the muscle during excision and mounting procedures. Inhomogeneities between the healthy central and weakened end portions of the muscle make it difficult to interpret studies where only total muscle length is controlled. Measurement and control of central segment length is clearly desirable but fraught with technical difficulties. We present a novel application of adaptive control methods that minimizes the difficulties encountered with current control techniques. This method, which allows control of either segment length or force, takes advantage of the repetitive, periodic nature of contractions. Here deviations of measured segment length or force signals from a desired response during one twitch are used to modify the muscle length command signal for use on the next twitch. This process continues for successive twitches until either segment length or force is within desired limits. The adaptive method allows greater stability and immunity to noise than classical feedback strategies.

Algorithms↗
PubMed1989

Long-term versus intrabeat history of ejection as determinants of canine ventricular end-systolic pressure.

We studied the effect of ejection on end-systolic pressure in isolated heart preparations. Ejecting beats were compared with isovolumic beats having the same volume as at end systole. While holding end-systolic volume constant, various stroke volumes, including negative stroke volumes (volume injected during systole), were imposed using a predetermined volume command. After switching contraction mode between ejecting and isovolumic, we measured the immediate and steady changes in end-systolic pressure. In the first isovolumic beat after switching from steady-state ejecting beats, the change in end-systolic pressure was variable, depending on the stroke volume. The end-systolic pressure of the ejecting beat exceeded that of the isovolumic beat on average by up to 18 mm Hg with small stroke volume, but the ejecting end-systolic pressure became lower than isovolumic with either large stroke volume (stroke volume/end-systolic volume less than 0.96) or with negative stroke volume. During the transient phase following a switch from ejecting to isovolumic, the end-systolic pressure gradually decreased to a steady state. Consequently, even in steady state, ejecting end-systolic pressure exceeded isovolumic pressure over a significant range of stroke volume (stroke volume/end-systolic volume less than 1.18). After returning contraction mode from isovolumic back to ejecting, we observed responses that were a mirror image. These results indicated that in addition to negative uncoupling effect, ejection exerts positive effects on ventricular end-systolic pressure that are manifest both quickly and gradually. We hypothesized that the mechanism responsible for the positive effect is length-dependent activation via the larger volume (both at the initiation of contraction and averaged over a cardiac cycle) of a beat that ejects compared to one held isovolumic at end-systolic volume. The results with volume injection were consonant with this concept.

Animals↗
PubMed1989

End-systolic pressure as a balance between opposing effects of ejection.

Ejection has previously been thought to exert only negative effects on end-systolic left ventricular pressure, via mechanisms like shortening deactivation and the force-velocity relation. Whether ejection also exerted a positive influence on pressure generation was tested by comparing two successive beats: 1) the last beat of steady-state ejection versus 2) a totally isovolumic contraction at the end-systolic volume. In 12 isolated, blood-perfused canine hearts loaded with a simulated arterial system, ejecting end-systolic pressure exceeded isovolumic pressure by approximately 10 mm Hg when ejection fraction was 0.3. With both higher and lower ejection fractions, the excess of ejecting end-systolic pressure was smaller; beyond an ejection fraction of roughly 0.5, the trend reversed so that ejecting end-systolic pressure fell below isovolumic pressure. The maximum excess in ejecting end-systolic pressure was quite variable (1-17 mm Hg), but the pattern of its variation with ejection fraction was consistent. A correlate of the positive effect of ejection on ventricular pressure was found in the timing of end systole. For an ejection fraction of 0.4, the systolic duration of ejecting beats was approximately 45% longer than in isovolumic beats (range, 23-67%). Potentially, a positive effect of ejection might be due to a residual influence of the stronger activation of cardiac myofilaments early in ejecting systole during which the sarcomeres were at longer lengths than in the isovolumic beat at end-systolic volume (length-dependent activation). A hypothetical model based on this mechanism reproduced both of the positive effects of ejection that were observed: excess end-systolic pressure and prolonged duration of systole. Thus, the approximate load independence of end-systolic pressure could result from the counter balance between opposing influences of ejection.

Animals↗
PubMed1988

Effect of isoproterenol on force transient time course and on stiffness spectra in rabbit papillary muscle in barium contracture.

To determine whether catecholamines produce alterations in myocardial myosin-actin cycling kinetics, we investigated the effects of isoproterenol upon mechanical characteristics of constantly activated heart muscle thought to reflect crossbridge behavior. In isolated rabbit right ventricular papillary muscles in barium contracture at 24 degrees C, we found that 10 microM isoproterenol caused: (a) a 23% reduction of the 10 to 90% rise time of slow tension recovery in force transients induced by rapid, small amplitude stretches; and (b) a 23% increase in the frequency of sinusoidal length perturbation at which stiffness amplitude exhibited a minimum. Based upon previous mechanistic interpretations of force transients, and on an analysis developed here to relate crossbridge events to the frequency-dependence of stiffness, we argue that our observations provide evidence that isoproterenol induces an acceleration of crossbridge cycling rate. This raises the intriguing prospect that beta-adrenergic stimulation regulates contraction, not only by well-known alterations in calcium metabolism, but also by intrinsic modulation of the force-generating machinery itself.

Animals↗
PubMed1988

Effect of nitroglycerin on aortic impedance, diameter, and pulse-wave velocity.

The effects of an intravenous infusion of 1 microgram/kg/min nitroglycerin were studied on systemic arterial properties in nine acutely instrumented dogs. Aortic impedance and pulse-wave velocity were calculated from measured pressure and flow signals collected during random ventricular pacing. Central aortic diameter was simultaneously determined with ultrasonic dimension crystals. Mean blood pressure was maintained constant to avoid the confounding effects of passive, pressure-induced changes in vascular properties. Nitroglycerin both reduced the amplitude of peripheral vascular reflections and delayed the return of these reflections to the aortic root. This reflection delay was manifested as a consistent leftward shift in both impedance modulus and phase. The magnitude of this reflection delay could not be entirely accounted for on the basis of the measured changes in average pulse-wave velocity along the aorta.

Animals↗
PubMed1987

Quantitative comparison of canine right and left ventricular isovolumic pressure waves.

The mechanical properties of the right and left ventricles (RV and LV) have previously been studied separately. However, because of differences in RV and LV architecture, geometry, and muscle mass, it is not obvious how the properties of the two chambers would relate to each other. This study compared the time courses of RV and LV isovolumic pressure waves (LVP, RVP, respectively) measured simultaneously in the same heart. We compared RVP and LVP in each of five isolated, supported canine hearts after pentobarbital anesthesia. RV and LV volumes were varied independently so that on various beats peak LVP exceeded, equaled, or was less than peak RVP. There was a delay of approximately 35 ms between the onset of LV and RV pressure waves with atrial pacing, but only 5 ms with ventricular pacing. LVP and RVP were measured and digitized at a sampling rate of 200 Hz. Pressure waves were offset and rescaled by their respective amplitudes so that for each beat the pressure wave had a minimum value of 0% at end diastole and a maximum value of 100% at end systole. RVP was then shifted in time so that its upstroke was synchronous with that of the LVP at the point of 50% of maximal developed pressure. The rescaled, time-shifted RVP was plotted as a function of the rescaled LVP for each point of the cardiac cycle, and the relation between the two was quantified by their root mean square difference (Drms). Drms averaged 2.3 +/- 1.5% (SD) for the first half of contraction, 1.5 +/- 0.4% for the second half of contraction, and 4.6 +/- 1.6% during relaxation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗