AJP - Heart Fuel your research with LabChart
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Am J Physiol Heart Circ Physiol 281: H2385-H2391, 2001;
0363-6135/01 $5.00
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (9)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Moore, T. D.
Right arrow Articles by Belenkie, I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Moore, T. D.
Right arrow Articles by Belenkie, I.
Vol. 281, Issue 6, H2385-H2391, December 2001

Ventricular interaction and external constraint account for decreased stroke work during volume loading in CHF

Thomas D. Moore1, Michael P. Frenneaux1, Rozsa Sas2,1, J. J. Atherton3, Jayne A. Morris-Thurgood1, Eldon R. Smith2, John V. Tyberg2, and Israel Belenkie2,1

2 Departments of Medicine and Physiology and Biophysics, University of Calgary, Calgary, Alberta T2N 4N1, Canada; 3 University of Queensland, Brisbane Q4029, Australia; and 1 Department of Cardiology, Wales Heart Research Institute, University of Wales College of Medicine, Cardiff CF14 4XN, United Kingdom

The slope of the stroke work (SW)-pulmonary capillary wedge pressure (PCWP) relation may be negative in congestive heart failure (CHF), implying decreased contractility based on the premise that PCWP is simply related to left ventricular (LV) end-diastolic volume. We hypothesized that the negative slope is explained by decreased transmural LV end-diastolic pressure (LVEDP), despite the increased LVEDP, and that contractility remains unchanged. Rapid pacing produced CHF in six dogs. Hemodynamic and dimension changes were then measured under anesthesia during volume manipulation. Volume loading increased pericardial pressure and LVEDP but decreased transmural LVEDP and SW. Right ventricular diameter increased and septum-to-LV free wall diameter decreased. Although the slopes of the SW-LVEDP relations were negative, the SW-transmural LVEDP relations remained positive, indicating unchanged contractility. Similarly, the SW-segment length relations suggested unchanged contractility. Pressure surrounding the LV must be subtracted from LVEDP to calculate transmural LVEDP accurately. When this was done in this model, the apparent decrease in contractility was no longer evident. Despite the increased LVEDP during volume loading, transmural LVEDP and therefore SW decreased and contractility remained unchanged.

congestive heart failure; hemodynamics; pericardium


This article has been cited by other articles:


Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
J. R. Mitchell, W. A. Whitelaw, R. Sas, E. R. Smith, J. V. Tyberg, and I. Belenkie
RV filling modulates LV function by direct ventricular interaction during mechanical ventilation
Am J Physiol Heart Circ Physiol, August 1, 2005; 289(2): H549 - H557.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
R A Bleasdale and M P Frenneaux
Cardiac resynchronisation therapy: when the drugs don't work.
Heart, December 1, 2004; 90(suppl_6): vi2 - vi4.
[Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
I. Belenkie, R. Sas, J. Mitchell, E. R. Smith, and J. V. Tyberg
Opening the pericardium during pulmonary artery constriction improves cardiac function
J Appl Physiol, March 1, 2004; 96(3): 917 - 922.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. Kawaguchi, I. Hay, B. Fetics, and D. A. Kass
Combined Ventricular Systolic and Arterial Stiffening in Patients With Heart Failure and Preserved Ejection Fraction: Implications for Systolic and Diastolic Reserve Limitations
Circulation, February 11, 2003; 107(5): 714 - 720.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Visit Other APS Journals Online