|
|
||||||||
1 Division of Thoracic and
Cardiovascular Surgery,
In previous studies, we observed left
ventricular (LV) systolic and diastolic dysfunction in association with
interstitial myocardial edema (IME) induced by either coronary venous
hypertension (CVH) or lymphatic obstruction. In the present study, we
examined the effects of myocardial edema induced by acute
hypoproteinemia (HP) on LV systolic and diastolic function. We also
combined the methods of HP and CVH (HP-CVH) to determine their combined
effects on LV function and myocardial water content (MWC). We used a
cell-saving device to lower plasma protein concentration in HP and
HP-CVH groups. CVH was induced by inflating the balloon in the coronary sinus. Six control dogs were treated to sham HP. Conductance and micromanometer catheters were used to assess LV function.
Contractility, as measured by preload recruitable stroke work, did not
change in control or HP groups but declined significantly (14.5%) in the HP-CVH group. The time constant of isovolumic LV pressure decline
(
) increased significantly from baseline by 3 h in the HP (24.8%)
and HP-CVH (27.1%) groups. The end-diastolic pressure-volume relationship (stiffness) also increased significantly from baseline by
3 h in the HP (78.6%) and HP-CVH (42.6%) groups. Total plasma protein
concentration decreased from 5.2 ± 0.2 g/dl at baseline to 2.5 ± 0.0 g/dl by 3 h in the HP and HP-CVH groups. MWC of the HP (79.8 ± 0.25%) and HP-CVH groups (79.8 ±0.2%) were significantly greater than that of the control group (77.8 ± 0.3%) but not
different from one another. In conclusion,
hypoproteinemia-induced myocardial edema was associated
with diastolic LV dysfunction but not systolic dysfunction. The edema
caused by hypoproteinemia was more than twice that produced by our
previous models, yet it was not associated with systolic dysfunction.
CVH had a negative inotropic effect and no significant influence on
MWC. IME may not have the inverse causal relationship with LV
contractility that has been previously postulated but appears to have a
direct causal association with diastolic stiffness as has been
previously demonstrated.
colloid osmotic pressure; contractility; compliance; myocardial water content
This article has been cited by other articles:
![]() |
C. S. Cox Jr, H. Sauer, S. J. Allen, L. M. Buja, and G. A. Laine Sodium/hydrogen-exchanger inhibition during cardioplegic arrest and cardiopulmonary bypass: An experimental study J. Thorac. Cardiovasc. Surg., May 1, 2002; 123(5): 959 - 966. [Abstract] [Full Text] [PDF] |
||||
![]() |
U. Mehlhorn, H. J. Geissler, G. A. Laine, and S. J. Allen Myocardial fluid balance Eur. J. Cardiothorac. Surg., December 1, 2001; 20(6): 1220 - 1230. [Abstract] [Full Text] [PDF] |
||||
![]() |
J C Nilsson, G Nielsen, B A Groenning, T Fritz-Hansen, L Sondergaard, G B Jensen, and H B W Larsson Sustained postinfarction myocardial oedema in humans visualised by magnetic resonance imaging Heart, June 1, 2001; 85(6): 639 - 642. [Abstract] [Full Text] |
||||
![]() |
R. H. Stewart, H. J. Geissler, S. J. Allen, and G. A. Laine Protein washdown as a defense mechanism against myocardial edema Am J Physiol Heart Circ Physiol, October 1, 2000; 279(4): H1864 - H1868. [Abstract] [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |