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PubMed1988

Gated radionuclide ventriculography in the evaluation of cardiac function in Duchenne's muscular dystrophy.

Left ventricular ejection fractions were determined in 38 patients with Duchenne's muscular dystrophy. No significant correlation between the severity of respiratory dysfunction or age and cardiac function was seen. We suggest that the cardiac status of each patient should be evaluated separately from his respiratory status, particularly when long-term assisted ventilation is being considered.

Adolescent↗
PubMed2001

A cardiac myocyte vascular endothelial growth factor paracrine pathway is required to maintain cardiac function.

The role of the cardiac myocyte as a mediator of paracrine signaling in the heart has remained unclear. To address this issue, we generated mice with cardiac myocyte-specific deletion of the vascular endothelial growth factor gene, thereby producing a cardiomyocyte-specific knockout of a secreted factor. The hearts of these mice had fewer coronary microvessels, thinned ventricular walls, depressed basal contractile function, induction of hypoxia-responsive genes involved in energy metabolism, and an abnormal response to beta-adrenergic stimulation. These findings establish the critical importance of cardiac myocyte-derived vascular endothelial growth factor in cardiac morphogenesis and determination of heart function. Further, they establish an adult murine model of hypovascular nonnecrotic cardiac contractile dysfunction.

Animals↗
PubMed1979

Cardiac function and morphology with aging in the spontaneously hypertensive rat.

To determine the effects of a chronic pressure load on cardiac function and morphology, spontaneously hypertensive rats (SHR) and two normotensive strains of Wistar rats (WKY and NWR) were studied under ether anesthesia at 13, 25, 52, and 90 wk of age. Although resting cardiac index of the SHR was comparable to that of WKY and NWR at all ages, the peak cardiac output and peak stroke volume per gram of left ventricle determined during a rapid intravenous infusion of Tyrode solution was markedly reduced in the SHR only at 90 wk of age. Autonomic inhibition did not alter the peak stroke volume attained, but reduced peak cardiac output at all ages in each of the strains. Absolute left ventricular dimensions in the SHR increased out of proportion to body growth, consistent with concentric hypertrophy. As peak pumping ability markedly declined from 52 to 90 wk of age in the SHR, the free wall of the left ventricle greatly thickened whereas the septum remained unchanged. At this time the right ventricle also hypertrophied. This disproportionate thickening of the walls of the left ventricle and the hypertrophy of the right ventricle were reflected in measurements of their fiber diameters. These alterations in ventricular architecture may contribute to the decrease in pumping ability observed in long-standing hypertension.

Aging↗
PubMedDate not supplied

Cardiac function in healthy infants and children: Doppler echocardiographic evaluation.

To establish normal values for Doppler-derived parameters of cardiac function, pulsed-wave Doppler recordings from the ascending aorta were obtained in 80 healthy infants and children. Stroke and minute distance, peak velocity, mean acceleration, acceleration and ejection time intervals, and the acceleration/ejection time ratios were measured or calculated from the Doppler recordings. The relations between the Doppler parameters and heart rate, age, and body surface area were analyzed separately for the children below and above 6 months of age. The normal values for the two groups are given as the median and range and as the mean and standard deviations, respectively. For the older age group, strong negative correlations with heart rate were found for stroke distance and ejection time, suggesting that these parameters should be evaluated in relation to heart rate. Intraobserver and interobserver reproducibility were studied in 10 children. Good reproducibility was found for stroke and minute distance, peak velocity, and left ventricular ejection time. For measurements related to acceleration, the reproducibility was less good.

Adolescent↗
PubMed1998

Cardiac function in patients with treated hypertension during aortic aneurysm repair.

OBJECTIVES: To investigate the impact of arterial hypertension on cardiac function during aortic cross-clamping and declamping. DESIGN: Prospective study. SETTING: University hospital. PARTICIPANTS: Twenty treated hypertensive males with slight left ventricular hypertrophy and 10 normotensive controls undergoing elective repair of an abdominal aortic aneurysm. INTERVENTIONS: Using transesophageal echocardiography, the mitral inflow profile was evaluated during aortic cross-clamping and declamping. MEASUREMENTS AND MAIN RESULTS: During the clamping period, the ratio of peak atrial to peak early filling velocity (PA/PE) was significantly higher in the hypertensive patients. One minute after aortic cross-clamping, mean arterial pressure (MAP) and pulmonary artery occlusion pressure significantly increased in the hypertensive patients, whereas they did not change in the normotensive group. Cardiac index and heart rate significantly decreased after cross-clamping, and increased after clamp release in both groups. PA/PE significantly dropped in both groups after aortic declamping, and returned to baseline values thereafter. MAP also decreased significantly in both groups after clamp release, but the fall of MAP tended to be more pronounced in the hypertensive patients. CONCLUSIONS: In the treated hypertensive patients, more pronounced hemodynamic and echocardiographic responses to aortic cross-clamping probably mirror the altered diastolic left ventricular function in these patients. With respect to intraoperative management, however, the treated hypertensive patients did not react grossly differently from the normotensive controls.

Aged↗
PubMedDate not supplied

Assessment of cardiac function by echocardiography in Paget's disease of bone.

OBJECTIVE: To identify the mechanisms which influence the development of cardiac insufficiency in Paget's disease of bone (PD). METHODS: In this hospital-based case-control study 23 consecutive, recently diagnosed and untreated PD patients were compared against 23 controls frequency-matched by sex, age and body index. All subjects underwent non-invasive assessment of cardiac function by two-dimensional Doppler echocardiography. Calcium, phosphate, and creatinine were determined in the serum and urine, along with alkaline phosphatase and hydroxyproline excretion, two biochemical parameters of PD activity. RESULTS: Peripheral vascular resistance proved lower (1604.9 +/- 390.1 vs 1801.2 +/- 421.0) and the stroke volume higher in PD patients (67.2 +/- 14.4 vs 56.0 +/- 8.6; p = 0.07) compared with controls. These differences were greater (1504.7 +/- 289.9 and 71.0 +/- 6.2) and attained statistical significance (p = 0.008) when the subgroup with more extensive skeletal disease only was considered. A moderate correlation was observed between hydroxyproline excretion and the E/A ratio (r = 0.45; p = 0.03), peripheral vascular resistance (r = -0.42; p = 0.04), and diastolic arterial pressure (r = -0.42; p = 0.04). The final model obtained via multivariate analysis identified both urinary hydroxyproline and age as predictive variables linked to peripheral vascular resistance. CONCLUSION: In the early phases of PD there is a trend towards a reduction in peripheral vascular resistance. If this persists, it may lead progressively to increased cardiac output, which is mainly influenced by the degree of turnover impairment and the age of the individual.

Aged↗
PubMed1985

Quantitation of cardiac function by cine-CT.

The recent introduction of a millisecond CT scanner specifically designed for cinematographic real-time imaging of the heart is a significant advance, and its introduction could parallel the impact that cineangiography had on cardiac diagnosis. A major advantage of CT is that central catheterization for angiographic purposes is avoided, as relatively small amounts of intravenous contrast medium provide excellent CT contrast enhancement of the blood pool and cardiac structures. In this article, the cine-CT scanner and the scanning techniques involved are described briefly, and the methods used to analyze CT data are discussed. The initial results are described, as is the potential of cine-CT for quantitating cardiac function.

Cardiac Output↗
PubMed1995

Early abnormalities of cardiac function in non-insulin-dependent diabetes mellitus and impaired glucose tolerance.

The aim of this study was to evaluate the role of diabetes and minor abnormalities of glucose homeostasis, such as impaired glucose tolerance, as determinants of cardiac function and structure in a working population. We studied a population-based sample of 64 telephone company employees (both sexes, mean age 58 years): 25 with normoglycemia, 15 with impaired glucose tolerance, and 24 with non-insulin-dependent diabetes mellitus (NIDDM) diagnosed by oral glucose tolerance test according to the recommendations of the World Health Organization. Subjects with myocardial ischemia were excluded. Left ventricular end-systolic dimension, indexed to body surface area, was greater in those with NIDDM (p < 0.05) and in those with impaired glucose tolerance (p < 0.05) with respect to normoglycemic persons. The ratio of the peak early diastolic velocity wave to the late diastolic wave was lower in those with NIDDM (p < 0.05) and in those with impaired glucose tolerance (p < 0.05) than in participants with normoglycemia. Body mass index and blood pressure were similar in the 3 groups. These results clearly indicate that early abnormalities of cardiac structure and function are observed not only in patients with NIDDM, but also in those with impaired glucose tolerance, independent of the confounding role of myocardial ischemia, body weight, and blood pressure.

Adult↗
PubMed1989

Measurement of hepatocellular function, cardiac output, effective blood volume, and oxygen saturation in rats.

The available techniques do not permit the measurement of hepatocellular function, cardiac output, effective blood volume, and oxygen saturation in small animals without the need of blood or tissue sampling. We present methodology that permits us to measure the above variables in the rat. Multiple doses of indocyanine green (ICG; 0.16-2.6 mg/kg) were given to pentobarbital-anesthetized rats, and [ICG] was continuously measured by an in vivo hemoreflectometer. Initial velocity of clearance (Vo) was determined from the [ICG] vs. time plot for each dose by nonlinear regression. The maximal velocity of clearance (Vmax; indicating hepatocellular function) was calculated. Vmax was 1) accurately determined using two, three, or four doses of ICG; 2) it was 1.09 +/- 0.16 mg.kg-1.min-1, not different from the Vo of the near-saturating dose of 25 mg/kg; and 3) it decreased after partial hepatectomy. Cardiac output was 41.89 +/- 1.46 ml.100 g-1.min-1, effective blood volume was 6.12 +/- 0.34 ml/100 g, and oxygen saturation was 92 +/- 2%. These methodologies may prove useful in the evaluation of hepatocellular dysfunction and hemodynamic parameters in the rat during and after various diseased states.

Animals↗
PubMed1996

Depression of cardiac function after deep hypothermic circulatory arrest in deeply anesthetized neonatal lambs.

Cardiac dysfunction is common after neonatal cardiac operations. Previous in vivo studies in neonatal animal models however, have failed to demonstrate decreased left ventricular function after ischemia and reperfusion. Cardiac dysfunction may have been masked in these studies by increased endogenous catecholamine levels associated with the use of light halothane anesthesia. Currently, neonatal cardiac operations are often performed with deep opiate anesthesia, which suppresses catecholamine surges and may affect functional recovery. We therefore examined the recovery of left ventricular function after ischemia and reperfusion in neonatal lambs anesthetized with high-dose fentanyl citrate (450 micrograms/kg administered intravenously). Seven intact neonatal lambs with open-chest preparation were instrumented with left atrial and left ventricular pressure transducers, left ventricular dimension crystals, and a flow transducer. The lambs were cooled (< 18 degrees C) on cardiopulmonary bypass (22 +/- 6 minutes), exposed to deep hypothermic circulatory arrest (46 +/- 1 minutes), and rewarmed on cardiopulmonary bypass (30 +/- 10 minutes). Catecholamine levels and indexes of left ventricular function were determined before (baseline) and 30, 60, 120, 180, and 240 minutes after termination of cardiopulmonary bypass. Levels of epinephrine, norepinephrine, and dopamine were unchanged from baseline values. Left ventricular contractility (slope of end-systolic pressure-volume relationship) was depressed from baseline value (31.7 +/- 9.3 mm Hg/ml) at 30 minutes (15.7 +/- 6.4 mm Hg/ml) and 240 minutes (22.7 +/- 6.4 mm Hg/ml) but unchanged between 60 and 180 minutes. Left ventricular relaxation (time constant of isovolumic relaxation) was prolonged from baseline value (19.0 +/- 3.0 msec) at 30 minutes (31.4 +/- 10.0 msec) and 240 minutes (22.1 +/- 2.8 msec) but unchanged between 60 and 180 minutes. Afterload (left ventricular end-systolic meridional wall stress) was decreased at 30, 60, and 240 minutes. Indexes of global cardiac function (cardiac output, stroke volume), preload (end-diastolic volume), and left ventricular compliance (elastic constant of end-diastolic pressure-volume relationship) were unchanged from baseline values. In deeply anesthetized neonatal lambs exposed to ischemia and reperfusion, left ventricular contractility, relaxation, and afterload are markedly but transiently depressed early after reperfusion and mildly depressed late after reperfusion.

Animals↗
PubMed1991

[Modern techniques of assistance and mechanical replacement of cardiac function].

There has been intensive technological and clinical research for many years into the assistance and mechanical replacement of cardiac function. The simplest systems (extracorporeal circulation using centrifuge pumps, hemopump) and more complex systems (orthotopic or heterotopic pneumatic ventricles, electric ventricles) have been shown to be effective in a variety of situations which up to now could not be controlled by pharmacological methods. These situations are made amenable to improvement by the application of these techniques. They make it possible to await the recovery of autonomous function or, in its absence, transplantation. Experience over the past 30 years provides guidance for current research into the artificial heart.

Heart Diseases↗
PubMed1992

Influence of pregnancy on mean systemic filling pressure and the cardiac function curve in guinea pigs.

To assess the degree of circulatory fullness and to evaluate the influence of peripheral and cardiac factors in the regulation of cardiac output during pregnancy, the following studies were conducted using pentobarbital-anesthetized, open-chest nonpregnant and late term pregnant guinea pigs. Mean circulatory filling pressure was taken as the equilibrium pressure when the pulmonary artery was constricted. Total vascular compliance was assessed by +/- 5-mL changes in blood volume performed while this constriction was maintained. A separate group of guinea pigs was prepared with a pulmonary artery electromagnetic flow probe and right atrial catheter. Rapid infusion of saline was used to increase right atrial pressure while the cardiac output was determined. Pregnancy was characterized by the following changes relative to nonpregnant controls: 51Cr-labelled RBC blood volume increased from 55 +/- 3 to 67 +/- 3 mL/kg; mean circulatory filling pressure increased from 7.1 +/- 0.2 to 8.0 +/- 0.5 mmHg (1 mmHg = 133.322 Pa); right atrial pressure decreased from 3.4 +/- 0.2 to 2.1 +/- 0.3 mmHg; and cardiac output increased from 71.8 +/- 3.9 to 96.8 +/- 3.3 mL.min-1.kg-1. Total vascular compliance was not changed (2.1 +/- 0.1 mL.kg-1.mmHg-1) and most of the expanded blood volume was accommodated as unstressed volume. The cardiac function curve was shifted upwards in pregnant animals. The resistance to venous return, as determined from the slope of the venous return curves, was not changed. These data suggest that the circulation of the pregnant guinea pig is slightly overfilled.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

[Effects of NaHCO3 on cardiac function and metabolism during hypoxic metabolic acidosis--2: Rapid infusion of NaHCO3].

The effects of 1M sodium bicarbonate (NaHCO3) on cardiac function and myocardial metabolism during hypoxia were compared with those of 1M sodium chloride (NaCl) in anesthetized dogs. Metabolic acidosis was induced with inhalation of low fraction of oxygen (9%) for 2 hours. NaHCO3 (n = 9) or NaCl (n = 10) was infused intravenously in a half dose of 0.2 x body weight x base excess mEq in 30 seconds. This treatment was repeated five minutes later. In NaHCO3 group; with first infusion, both blood and intramyocardial pH increased. Left ventricular pressure (LVP) and maximum rate of rise of LVP (LV dP/dt max) were unchanged. Cardiac index (CI) tended to increase, while left ventricular end-diastolic pressure (LVEDP) and LVEDP/LVP increased significantly. In five dogs in which myocardial glucose uptake increased, LV dP/dt max increased. With the second infusion, inspite of the increase of blood and intramyocardial pH, LVP and LV dP/dt max decreased significantly compared with the preceding values. In NaCl group, with first infusion, blood and intramyocardial pH decreased. CI increased significantly, while LVP and LV dP/dt max tended to decrease, and LVEDP and LVEDP/LVP increased significantly. After the second infusion, myocardial contractility was depressed significantly. In both groups, blood lactate (LA) level increased significantly, especially with NaHCO3 infusion. LV dP/dt max correlated significantly with LA in NaCl group (r = -0.614, P < 0.001). However, in NaHCO3 group, LV dP/dt max did not correlate with LA. Blood glucose level (r = 0.612, P < 0.001) and myocardial glucose uptake (r = 0.718, P < 0.001) correlated significantly with LV dP/dt max in NaHCO3 group.(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis, Respiratory↗
PubMed1972

Changes during eating in oxygen consumption, cardiac function and body fluids of sheep.

1. A study was made of the changes taking place in O(2) consumption, cardiac function and the volume and composition of the body fluids of sheep while they consumed a meal of hay.2. During eating P(a, CO2) and P(v, CO2) both increased, pH decreased and free plasma [HCO(3) (-)] increased. Venous haematocrit increased sharply at the beginning of the meal, and declined slowly after feed was removed.3. Arterial P(O2) did not change significantly during eating. However P(v, O2) fell slightly but significantly. The O(2) saturation of venous blood fell due to the decline in pH. Estimated CO(2) in arterial blood increased as a consequence of increased haemoglobin content. The net effect was to increase arteriovenous difference in O(2) content from 4.4 ml./100 ml. before eating to 6.0 ml./100 ml. at the end of the meal.4. O(2) consumption increased about 60% during eating and fell rapidly thereafter. Heart rate followed a similar pattern. Cardiac output however increased only about 17%, from 6 to 7 l./min. Consequently stroke volume declined throughout the meal from 76 to 52 ml./beat.5. Plasma volume, estimated from measurements of T-1824, declined sharply by about 300 ml. at the beginning of the meal and recovered slowly after feed was removed. Blood volume declined less because of a rise in circulating erythrocytes.6. Extracellular fluid volume was estimated from measurements of thiocyanate and thiosulphate spaces. Thiocyanate space measurements were abandoned after thiocyanate was found to be concentrated in saliva. Considerable random variation occurred in measurements of changes in extracellular fluid from thiosulphate disappearance but the results did reveal a significant fall of 1000-1500 ml. in extracellular fluid volume during eating.7. The significance of these interrelated changes is discussed in relation to the maintenance of homoeostasis during eating in the sheep.

Animal Nutritional Physiological Phenomena↗
PubMed1995

[Cardiac function in isolated working rat heart with pressure overload hypertrophy: correlation with myocardial angiotensin II].

Using the isolated working rat heart model, we recorded cardiac function of the hypertrophied hearts induced by abdominal aortic banding and determined the myocardial angiotensin II level. Compared with the sham-operated control hearts, the maximal diastolic rate (-dp/dt) and coronary flow rate (per gram of left ventricular weight) were decreased, while the myocardial angiotensin II content was increased in the hypertrophied hearts. Correlation analysis revealed that both coronary flow rate (r = -0.8097, P < 0.001) and -dp/dt (r = -0.5463, P < 0.01) were negatively correlated to myocardial angiotensin II. We conclude that the activated cardiac renin-angiotensin system may be responsible for the decreased diastolic function and coronary reserve in the hypertrophied hearts.

Angiotensin II↗
PubMed1983

Cardiac function in adolescents and young adults with anorexia nervosa.

Twelve patients with anorexia nervosa (mean age 17.6 years) underwent noninvasive cardiac evaluation. All patients had normal sinus rhythm at rest, during exercise, and following 24-hr electrocardiographic monitoring. The chest roentgenograms demonstrated a small heart secondary to a loss of left ventricular mass. Three of four patients studied had left ventricular mass measurements less than 100 g (normal is 90-360 g). Most patients had an elevated heart rate response to exercise with a slightly blunted systolic and a normal diastolic blood pressure response. Eleven of the 12 patients had reduced overall maximal working capacity. All but one had normal left ventricular ejection fraction at rest. There was no evidence of arrhythmias at rest, during exercise, or with continuous electrocardiographic recording. Young patients with anorexia nervosa appeared to have essentially normal cardiac function with a reduction in left ventricular muscle mass.

Adolescent↗
PubMedDate not supplied

Recovery of cardiac function by long-term left ventricular support in patients with end-stage cardiomyopathy.

Effects of long-term left ventricular (LV) support on end-stage cardiomyopathy patients is unclear. We applied our LV assist system (LVAS) to six heart transplant candidates, aged 17 to 49, with dilated cardiomyopathy, including one dilated phase hypertrophied cardiomyopathy. LVAS was installed between the left atrium and the ascending aorta, and the pump was positioned parecorporeally. In all patients, their general condition improved, and their pump flows were kept at 4 to 5 L/min. Exercise was started after stabilization of their general condition under constant pump flow. Natural heart size and function were examined by echocardiography. In the beginning of assist, all patients showed impaired cardiac function and LV dilation. During LV assist, systolic function measured by ejection time improved in all patients. Left ventricular end-diastolic dimension (LVDd), showed a remarkable decrease in two patients, who were weaned from LVAS after 3 months of support. They are doing well more than 1 year and 3 years after removal; peak VO2 levels (ml/min/kg) were 30 at 1.2 years and 27 at 2.7 years after removal. In the other four patients, however, LVDd had no remarkable changes, and three could not be weaned from LVAS. The last was discontinued from LVAS after 5 months of support because of infection and died 2 months after removal. From this experience, long-term LVAS may provide the chance for recovery of the natural heart in patients with end-stage cardiomyopathy. The patients whose hearts showed remodeling were able to be weaned from LVAS, and their heart function maintained in good condition for several years.

Adolescent↗