This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Udelson, J. E. Articles by Bonow, R. O. Search for Related Content PubMed PubMed Citation Articles by Udelson, J. E. Articles by Bonow, R. O. Pubmed/NCBI databases Compound via MeSH Substance via MeSH

Circulation, Vol 82, 1174-1182, Copyright © 1990 by American Heart Association

ARTICLES

Minimum left ventricular pressure during beta-adrenergic stimulation in human subjects. Evidence for elastic recoil and diastolic "suction" in the normal heart

JE Udelson, SL Bacharach, RO Cannon 3d and RO Bonow
Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md.

The influence of elastic recoil and restoring forces on diastolic left ventricular pressure decay and minimum left ventricular pressures has been demonstrated in animal models but has not been studied in the human heart. To investigate this issue in the normal human left ventricle, we studied eight patients with chest pain and normal coronary arteries with simultaneous measurement of left ventricular volume (by radionuclide angiography) and pressure (by micromanometer catheter) and coronary sinus blood flow. Electrocardiographic-gated data were obtained in the basal state, during rapid atrial pacing, and during isoproterenol infusion to a similar heart rate. Compared with pacing, isoproterenol increased ejection fraction and reduced end- systolic volume (p less than 0.005), end-systolic pressure (p less than 0.005), and the half-time of pressure decline after peak negative dP/dt (T1/2) (p less than 0.001). Negative diastolic pressure developed in seven of eight patients during isoproterenol (range, -0.5 to -2.4 mm Hg) but in only one of eight during pacing (-0.2 mm Hg). These reduced diastolic pressures during isoproterenol were accompanied by increased stroke volume (reflecting increased transmitral flow) and diminished pulmonary wedge pressure (reflecting left atrial pressure). The magnitude of reduction in minimum diastolic pressure during pacing and isoproterenol was related to the change in end-systolic volume (r = 0.79, p less than 0.001), ejection fraction (r = -0.74, p less than 0.001), T1/2 (r = -0.57, p less than 0.02), and coronary sinus flow (r = 0.73, p less than 0.005). Stronger correlations were observed in analyzing changes during isoproterenol alone.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				M. K. Stickland, R. C. Welsh, S. R. Petersen, J. V. Tyberg, W. D. Anderson, R. L. Jones, D. A. Taylor, M. Bouffard, and M. J. Haykowsky Does fitness level modulate the cardiovascular hemodynamic response to exercise? J Appl Physiol, June 1, 2006; 100(6): 1895 - 1901. [Abstract] [Full Text] [PDF]

				R. Yotti, J. Bermejo, J. C. Antoranz, M. M. Desco, C. Cortina, J. L. Rojo-Alvarez, C. Allue, L. Martin, M. Moreno, J. A. Serrano, et al. A Noninvasive Method for Assessing Impaired Diastolic Suction in Patients With Dilated Cardiomyopathy Circulation, November 8, 2005; 112(19): 2921 - 2929. [Abstract] [Full Text] [PDF]

				B. Biondi, E. A. Palmieri, G. Lombardi, and S. Fazio Effects of Thyroid Hormone on Cardiac Function - The Relative Importance of Heart Rate, Loading Conditions, and Myocardial Contractility in the Regulation of Cardiac Performance in Human Hyperthyroidism J. Clin. Endocrinol. Metab., March 1, 2002; 87(3): 968 - 974. [Abstract] [Full Text] [PDF]

				T. Rowland, E. Mannie, and L. Gawle Dynamics of Left Ventricular Diastolic Filling During Exercise : A Doppler Echocardiographic Study of Boys 10 to 14 Years Old Chest, July 1, 2001; 120(1): 145 - 150. [Abstract] [Full Text] [PDF]

				S. F. Nagueh, H. Sun, H. A. Kopelen, K. J. Middleton, and D. S. Khoury Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler J. Am. Coll. Cardiol., January 1, 2001; 37(1): 278 - 285. [Abstract] [Full Text] [PDF]

				D. Chemla, C. Coirault, J.-L. Hebert, and Y. Lecarpentier Mechanics of Relaxation of the Human Heart Physiology, April 1, 2000; 15(2): 78 - 83. [Abstract] [Full Text] [PDF]

				S. G. De Hert, P. J. Van der Linden, P. W. T. Broecke, I. E. Rodrigus, L. A. Sermeus, A. C. Moulijn, and T. C. Gillebert The Effects of {beta}-Adrenergic Stimulation on the Length-Dependent Regulation of Myocardial Function in Coronary Surgery Patients Anesth. Analg., October 1, 1999; 89(4): 835 - 835. [Abstract] [Full Text] [PDF]

				E. Coodley Newer Drug Therapy for Congestive Heart Failure Arch Intern Med, June 14, 1999; 159(11): 1177 - 1183. [Abstract] [Full Text] [PDF]

				M. R. Moon, A. F. Bolger, A. DeAnda, M. Komeda, G. T. Daughters II, S. D. Nikolic, D. C. Miller, and N. B. Ingels Septal Function During Left Ventricular Unloading Circulation, March 4, 1997; 95(5): 1320 - 1327. [Abstract] [Full Text]

				S. Teramura, T. Yamakado, M. Maeda, and T. Nakano Effects of MCI-154, a Calcium Sensitizer, on Left Ventricular Systolic and Diastolic Function in Pacing-Induced Heart Failure in the Dog Circulation, February 4, 1997; 95(3): 732 - 739. [Abstract] [Full Text]