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 Applegate, R. J. Search for Related Content PubMed PubMed Citation Articles by Applegate, R. J. Pubmed/NCBI databases Compound via MeSH Substance via MeSH

Circulation, Vol 83, 661-673, Copyright © 1991 by American Heart Association

ARTICLES

Load dependence of left ventricular diastolic pressure-volume relations during short-term coronary artery occlusion

RJ Applegate
Department of Medicine, Bowman Gray School of Medicine, Winston-Salem, N.C. 27103.

We evaluated the effect of altered loading conditions on left ventricular (LV) diastolic pressure-volume relations during acute coronary artery occlusion that was produced by inflation of an intracoronary balloon. Open-chest anesthetized dogs (n = 18) were instrumented so that LV pressure (micromanometer) and LV volume (conductance) could be measured without disturbing the pericardium. The effects of brief periods of occlusion (1-2 minutes) were assessed under steady-state conditions before and after dextran infusion with the pericardium present and absent and during vena caval occlusion. Under steady-state conditions before dextran infusion with the pericardium removed, at an LV end-diastolic pressure (EDP) of 8.4 +/- 1.4 mm Hg, occlusion resulted in a rightward shift in the diastolic portion of the LV pressure-volume loop (delta LVEDP, 2.7 +/- 2.3 mm Hg; delta LVEDV, 6.3 +/- 4.7 ml, both p less than 0.05 versus control). After dextran infusion (LVEDP, 20.9 +/- 6.0 mm Hg), occlusion resulted in a rightward and upward shift in the diastolic portion of the LV pressure-volume loop (delta LVEDP, 5.8 +/- 4.4 mm Hg; delta LVEDV, 4.2 +/- 3.0 ml, both p less than 0.05 versus control). At low cardiac volumes before dextran infusion, the intact pericardium did not affect the response to occlusion. By contrast, after dextran infusion in the presence of an intact pericardium, LVEDP significantly increased (delta, 6.4 +/- 3.6 mm Hg, p less than 0.05) but LVDEV did not (delta, 0.7 +/- 1.5 ml, p = NS). There was a parallel upward shift in the diastolic portion of the LV pressure-volume loop that was eliminated by removal of the pericardium. Thus, the change in LV diastolic pressure and volume during occlusion varied and depended on the baseline cardiac volume and presence of the pericardium. Before dextran infusion with the pericardium present and absent, coronary artery occlusion did not alter the LV diastolic chamber stiffness parameter, which was calculated from the diastolic interval of an averaged steady-state beat (0.040 +/- 0.019 versus 0.036 +/- 0.015 mm Hg/ml, p = NS). After dextran infusion with the pericardium present and absent, coronary artery occlusion increased the LV diastolic chamber stiffness parameter (0.057 +/- 0.034 and 0.074 +/- 0.034 mm Hg/ml, both p less than 0.05 versus controls, respectively). Vena caval occlusion eliminated the shifts in the diastolic portion of the LV pressure-volume loop with the pericardium present and absent.(ABSTRACT TRUNCATED AT 400 WORDS)

This article has been cited by other articles:

				H. A. Remah, H. Asanoi, S. Joho, A. Igawa, T. Kameyama, T. Nozawa, and H. Inoue Modulation of left ventricular diastolic distensibility by collateral flow recruitment during balloon coronary occlusion J. Am. Coll. Cardiol., August 1, 1999; 34(2): 500 - 506. [Abstract] [Full Text] [PDF]

				C. Stefanadis, J. Dernellis, E. Tsiamis, and P. Toutouzas Effects of pacing-induced and balloon coronary occlusion ischemia on left atrial function in patients with coronary artery disease J. Am. Coll. Cardiol., March 1, 1999; 33(3): 687 - 696. [Abstract] [Full Text] [PDF]

				C. I. Brookes, P. A. White, A. J. Bishop, P. J. Oldershaw, A. N. Redington, and N. E. Moat Validation of a new intraoperative technique to evaluateload-independent indices of right ventricular performance in patients undergoingcardiac operations J. Thorac. Cardiovasc. Surg., September 1, 1998; 116(3): 468 - 472. [Abstract] [Full Text]

				A. Bishop, P. White, P. Groves, R. Chaturvedi, C. Brookes, A. Redington, and P. Oldershaw Right ventricular dysfunction during coronary artery occlusion: pressure-volume analysis using conductance catheters during coronary angioplasty Heart, November 1, 1997; 78(5): 480 - 487. [Abstract] [Full Text] [PDF]

				H. Takano and S. A. Glantz Left Ventricular Contractility Predicts How the End-Diastolic Pressure-Volume Relation Shifts During Pacing-Induced Ischemia in Dogs Circulation, May 1, 1995; 91(9): 2423 - 2434. [Abstract] [Full Text]

				H. Takano and S. A Glantz Gadolinium Attenuates the Upward Shift of the Left Ventricular Diastolic Pressure-Volume Relation During Pacing-Induced Ischemia in Dogs Circulation, March 1, 1995; 91(5): 1575 - 1587. [Abstract] [Full Text]