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LV Pressure (lv + pressure)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

Induction of Angiogenesis and Inhibition of Apoptosis by Hepatocyte Growth Factor Effectively Treats Postischemic Heart Failure

JOURNAL OF CARDIAC SURGERY, Issue 1 2005
Vasant Jayasankar M.D.
Hepatocyte growth factor (HGF) is a potent angiogenic and anti-apoptotic protein whose receptor is upregulated following MI. This study was designed to investigate the ability of HGF to prevent heart failure in a rat model of experimental MI. Methods: The rats underwent direct intramyocardial injection with replication-deficient adenovirus encoding HGF (n = 7) or null virus as control (n = 7) 3 weeks following ligation of the left anterior descending coronary artery. Analysis of the following was performed 3 weeks after injection: cardiac function by pressure,volume conductance catheter measurements; LV wall thickness; angiogenesis by Von Willebrand's factor staining; and apoptosis by the TUNEL assay. The expression levels of HGF and the anti-apoptotic factor Bcl-2 were analyzed by Western blot. Results: Adeno-HGF-treated animals had greater preservation of maximum LV pressure (HGF 77 ± 3 vs. control 64 ± 5 mmHg, p < 0.05), maximum dP/dt (3024 ± 266 vs. 1907 ± 360 mmHg/sec, p < 0.05), maximum dV/dt (133 ± 20 vs. 84 ± 6 ,L/sec, p < 0.05), and LV border zone wall thickness (1.98 ± 0.06 vs. 1.53 ± 0.07 mm, p < 0.005). Angiogenesis was enhanced (151 ± 10.0 vs. 90 ± 4.5 endothelial cells/hpf, p < 0.005) and apoptosis was reduced (3.9 ± 0.3 vs. 8.2 ± 0.5%, p < 0.005). Increased expression of HGF and Bcl-2 protein was observed in the Adeno-HGF-treated group. Conclusions: Overexpression of HGF 3 weeks post-MI resulted in enhanced angiogenesis, reduced apoptosis, greater preservation of ventricular geometry, and preservation of cardiac contractile function. This technique may be useful to treat or prevent postinfarction heart failure. [source]

Effect of dantrolene in an in vivo and in vitro model of myocardial reperfusion injury

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2000
B. Preckel
Background: In skeletal muscle, dantrolene reduces free cytosolic calcium by inhibiting calcium release from the sarcoplasmic reticulum. A similar effect in ischemic-reperfused heart cells would protect myocardial tissue against reperfusion injury. We tested the hypothesis that dantrolene infusion during reperfusion protects the heart against reperfusion injury. Methods: Isovolumetric beating rat hearts were subjected to 30 min of ischemia followed by 60 min of reperfusion. Left ventricular (LV) developed pressure (LVDP) and creatine kinase release (CKR) were determined as indices of myocardial performance and cellular injury, respectively. In the treatment groups, dantrolene (25 (DAN25) or 100 (DAN100) ,mol l,1) was infused during the first 15 min of reperfusion; control hearts received the respective concentration of the vehicle (mannitol (CON25, CON100), each group n=7). To investigate the effects of dantrolene on reperfusion injury in vivo, 18 chloralose-anesthetized rabbits were subjected to 30 min occlusion and 180 min reperfusion of a major coronary artery. LV pressure (LVP), cardiac output (CO), and infarct size were determined. During the last 5 min of ischemia, nine rabbits received 10 mg kg,1 dantrolene intravenously (DAN). Another nine rabbits received the vehicle (dimethylsulfoxide) and served as controls (CON). Results: In isolated rat hearts, there was no recovery of LVDP in any group. Total CKR during 1 h of reperfusion was 845±76 (CON100) and 550±81 U g,1 dry mass (DAN100, P<0.05). In rabbits in vivo, hemodynamic baseline values were similar between groups (CON vs. DAN: LVP, 99±6 (mean±SEM) vs. 91±6mm Hg, P=0.29; CO, 252±26 vs. 275±23 ml min,1, P=0.53). During coronary artery occlusion, LVP and CO were reduced in both groups (CON: LVP, 89±3%; CO, 90±5% of baseline values) and LVP did not recover to baseline values during reperfusion (51±5% (CON) vs. 67±7% (DAN) of baseline, P=0.10). Infarct size was 41±4% of the area at risk in controls and 37±6% in dantrolene treated hearts (P=0.59). Conclusions: Dantrolene reduced CKR, indicating an attenuation of lethal cellular reperfusion injury in isolated rat hearts. However, in the rabbit in vivo, there was no effect on the extent of reperfusion injury after regional myocardial ischemia. [source]

Detection of Left Ventricle Function From a Magnetically Levitated Impeller Behavior

ARTIFICIAL ORGANS, Issue 5 2006
Hideo Hoshi
Abstract:, The magnetically levitated (Mag-Lev) centrifugal rotary blood pump (CRBP) with two-degrees-of-freedom active control is promising for safe and long-term support of circulation. In this study, Mag-Lev CRBP controllability and impeller behavior were studied in the simulated heart failure circulatory model. A pneumatically driven pulsatile blood pump (Medos VAD [ventricular assist device]-54 mL) was used to simulate the left ventricle (LV). The Mag-Lev CRBP was placed between the LV apex and aortic compliance tank simulating LV assistance. The impeller behavior in five axes (x, y, z, ,, and ,) was continuously monitored using five eddy current sensors. The signals of the x - and y -axes were used for feedback active control, while the behaviors of the other three axes were passively controlled by the permanent magnets. In the static mock circuit, the impeller movement was controlled to within ±10,±20 µm in the x- and y -axes, while in the pulsatile circuit, LV pulsation was modulated in the impeller movement with the amplitude being 2,22 µm. The amplitude of impeller movement measured at 1800 rpm with the simulated failing heart (peak LV pressure [LVP] = 70 mm Hg, mean aortic pressure [AoPmean] = 55 ± 20 mm Hg, aortic flow = 2.7 L/min) was 12.6 µm, while it increased to 19.2 µm with the recovered heart (peak LVP = 122 mm Hg, AoPmean = 100 ± 20 mm Hg, aortic flow = 3.9 L/min). The impeller repeated the reciprocating movement from the center of the pump toward the outlet port with LV pulsation. Angular rotation (,, ,) was around ±0.002 rad without z -axis displacement. Power requirements ranged from 0.6 to 0.9 W. Five-axis impeller behavior and Mag-Lev controller stability were demonstrated in the pulsatile mock circuit. Noncontact drive and low power requirements were shown despite the effects of LV pulsation. The impeller position signals in the x - and y -axes reflected LV function. The Mag-Lev CRBP is effective not only for noncontact low power control of the impeller, but also for diagnosis of cardiac function noninvasively. [source]

Increased plasma levels of natriuretic peptide type B and A in children with congenital heart defects with left compared with right ventricular volume overload or pressure overload

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 5 2005
Daniel Holmgren
Summary Aim:, Natriuretic peptide levels B (BNP) and A (ANP) have been described in children with congenital heart defects (CHD) with pressure and volume overload. However, the impact of ventricular morphology per se on natriuretic peptide levels has not been reported. The aim of the present study was to evaluate plasma BNP and ANP in children with CHD with left or right ventricular volume or pressure overload. Methods and results:, Plasma BNP and ANP were analysed in 61 children, median age 3·1 (0·3,16·2) years. Haemodynamic load was evaluated by echo-Doppler and/or catheterization measurements and classified as: pressure overload of the right (RV pressure) or left (LV pressure) ventricle, or volume overload of the right (RV volume) or left (LV volume) ventricle, of a sufficient degree to indicate surgery/catheter intervention. Twenty-three children, with a median age of 1·1 (0·1,8·3) years, without heart disease, served as controls for the natriuretic peptide measurements. Children in the LV volume group had significantly higher BNP and ANP values, 55·4 ng l,1 (10·7,352) and 164 (31·8,346), than children in the RV volume, 15·6 (0·0,105·1) and 57·2 (11·3,234·1), LV pressure, 6·8 (0·7,170) and 40·8 (12·6,210), and RV pressure, 18·0 (5·0,29·1) and 69·3 (8·7,182), groups respectively (P<0·0001). The values in the LV pressure group were close to the values in the Control group, 4·7 (0·0,17·7) and 32·9 (11·7,212·1), respectively (P = 0·051 and P = 0·378, respectively). Conclusions:, Plasma concentrations of BNP and ANP were higher in children with CHD with left ventricular volume overload compared with right ventricular volume overload or pressure overload. [source]

Single-beat estimation of the left ventricular end-systolic pressure,volume relationship in patients with heart failure

ACTA PHYSIOLOGICA, Issue 1 2010
E. A. Ten Brinke
Abstract Aim:, The end-systolic pressure,volume relationship (ESPVR) constructed from multiple pressure,volume (PV) loops acquired during load intervention is an established method to asses left ventricular (LV) contractility. We tested the accuracy of simplified single-beat (SB) ESPVR estimation in patients with severe heart failure. Methods:, Nineteen heart failure patients (NYHA III-IV) scheduled for surgical ventricular restoration and/or restrictive mitral annuloplasty and 12 patients with normal LV function scheduled for coronary artery bypass grafting were included. PV signals were obtained before and after cardiac surgery by pressure-conductance catheters and gradual pre-load reductions by vena cava occlusion (VCO). The SB method was applied to the first beat of the VCO run. Accuracy was quantified by the root-mean-square-error (RMSE) between ESPVRSB and gold-standard ESPVRVCO. In addition, we compared slopes (EES) and intercepts (end-systolic volume at multiple pressure levels (70,100 mmHg: ESV70,ESV100) of ESPVRSB vs. ESPVRVCO by Bland,Altman analyses. Results:, RMSE was 1.7 ± 1.0 mmHg and was not significantly different between groups and not dependent on end-diastolic volume, indicating equal, high accuracy over a wide volume range. SB-predicted EES had a bias of ,0.39 mmHg mL,1 and limits of agreement (LoA) ,2.0 to +1.2 mmHg mL,1. SB-predicted ESVs at each pressure level showed small bias (range: ,10.8 to +9.4 mL) and narrow LoA. Two-way anova indicated that differences between groups were not dependent on the method. Conclusion:, Our findings, obtained in hearts spanning a wide range of sizes and conditions, support the use of the SB method. This method ultimately facilitates less invasive ESPVR estimation, particularly when coupled with emerging noninvasive techniques to measure LV pressures and volumes. [source]