Circulation, Vol 53, 428-436, Copyright © 1976 by American Heart Association
I Palacios, RA Johnson, JB Newell and WJ Powell Jr
The mechanism of elevation of left ventricular end-diastolic pressure
during acute global ischemia was evaluated by examiniation of the relative
contributions of a decrease in contractility and an alteration of the
pressure-volume relationship. The external circumference
(mercury-in-silastic gauge) pressure relationship, as an index of the
pressure-volume relationship, was studied in beta adrenergic and ganglionic
blocked, open chest dogs on right heart bypass at constant heart rate ane
aortic pressure. Ischemia of one and two hours' duration was produced by
reducing total coronary blood flow in cannulated left and right coronary
arteries until left ventricular end-diastolic pressure rose significantly.
At a constant stroke work, left ventricular end-diastolic pressure rose
from 5.0 +/- 0.5 to 15.0 +/- 0.5 cm H2O in the experiments of one hour of
ischemia, and from 7.0 +/- 1.0 to 17.0 +/- 1.0 cm H2O in experiments of two
hours of ischemia. Ischemia was followed by one hour of restoration of
coronary blood flow. Ischemia produced a marked depression of ventricular
function: stroke work, considered at a left ventricular end-diastolic
pressure of 15 cm H2O, decreased from 21.0 +/- 3.0 to 3.5 +/- 0.5 gm-m, and
from 15.0 +/- 2.0 to 2.5 +/- 0.5 gm-m, in the experiments of one and two
hours, respectively. Neither ischemia nor reflow changed the pressure-
volume relationship. Thus, the elevation of left ventricular end- diastolic
pressure during ischemia in an otherwise normal canine myocardium is due to
a decrease in systolic performance of the heart rather than to an
alteration of the pressure-volume relationship.
ARTICLES
Left ventricular end-diastolic pressure volume relationships with experimental acute global ischemia
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