Conference proceeding
Inotropic stimulation and oxygen consumption in a canine model of dilated cardiomyopathy. Discussion
The Annals of thoracic surgery, v 52(4), pp 750-758
1991
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Abstract
Inotropic support for the dilated, failing ventricle results in complex hemodynamic changes affecting preload, afterload, contractility, and heart rate, each of which affects myocardial oxygen consumption. Appreciation of a hierarchy of hemodynamic determinants of myocardial oxygen consumption may be helpful to the clinician trying to balance oxygen demands and hemodynamic performance. We tested the hypothesis that epinephrine alters the hierarchy of hemodynamic determinants of myocardial oxygen consumption in a canine model of dilated cardiomyopathy created by rapid ventricular pacing. Dogs (n = 10) were instrumented to record left ventricular pressure and dimension, and a modified right heart bypass preparation was used to control left ventricular workload. Coronary sinus effluent was quantitatively collected and analyzed for oxygen content and used to calculate myocardial oxygen consumption. Epinephrine administration significantly increased myocardial oxygen consumption in the empty, beating heart; however, when the relationships of multiple determinants of left ventricular work and load were compared before and after epinephrine administration, no oxygen wasting effect was observed. Using multivariate linear regression analysis, a hierarchy of hemodynamic determinants of myocardial oxygen consumption was created. In the untreated heart, stroke work and cardiac output were the primary hemodynamic determinants of oxygen consumption; epinephrine significantly altered the determinants such that wall stress became the dominant hemodynamic determinant of myocardial oxygen consumption. Focused manipulation of wall stress in the treated, failing heart may limit the potentially deleterious effects of inotropic stimulation in this setting.
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Details
- Title
- Inotropic stimulation and oxygen consumption in a canine model of dilated cardiomyopathy. Discussion
- Creators
- C. M Dyke - Virginia Commonwealth UniversityK. F Lee - Virginia Commonwealth UniversityI. H Edmunds - Virginia Commonwealth UniversityJ Parmar - Virginia Commonwealth UniversityR. J Dignan - Virginia Commonwealth UniversityT. JR Yeh - Virginia Commonwealth UniversityA ABD-ELFATTAH - Virginia Commonwealth UniversityA. S Wechsler - Virginia Commonwealth UniversityG. J Magovern - Virginia Commonwealth UniversityR. A Guyton - Virginia Commonwealth University
- Publication Details
- The Annals of thoracic surgery, v 52(4), pp 750-758
- Conference
- Myocardial preservation into the 21st century (Oxford, England, 12 Aug 1990–15 Aug 1990)
- Publisher
- Elsevier Science
- Number of pages
- 9
- Grant note
- NHLBI NIH HHS: HL 26302-11
- Resource Type
- Conference proceeding
- Language
- English
- Academic Unit
- Cardiothoracic Surgery
- Web of Science ID
- WOS:A1991GM20100006
- Scopus ID
- 2-s2.0-0026001520
- Other Identifier
- 991020705349604721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery