Acute pulmonary microembolism induces different regional changes in preload and contraction pattern in canine right ventricle

Zwißler, Bernhard; Forst, H.; Meßmer, K.

doi:10.1093/cvr/24.4.285

Cited by 8 publications

(2 citation statements)

References 13 publications

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“…Greyson et al (11) observed an immediate RV regional dysfunction after brief RV pressure overload. We found out-ofphase beats immediately after PA occlusion, which was similar to the observation of Zwissler et al (36). PA occlusion produced mechanical disturbances within a given region, and among regions in RV.…”

Section: Discussionsupporting

confidence: 91%

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Stretch-induced regional mechanoelectric dispersion and arrhythmia in the right ventricle of anesthetized lambs

Chen

Penny

Greve

et al. 2004

American Journal of Physiology-Heart and Circulatory Physiology

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Regional mechanical and electrophysiological changes accompany most ventricular arrhythmias and, it has been suggested, by mechanoelectric feedback. We hypothesized that an intervention producing regional mechanical dispersion was associated with regional, proarrhythmic electrical dispersion and studied the regional mechanoelectric feedback in the right ventricle (RV) of anesthetized lambs. Ten lambs were deeply anesthetized, and their hearts were exposed. Three tripodal devices, each incorporating three monophasic action potential electrodes and an integrated strain-gauge system, were placed on the RV apex outflow and inflow regions. Measurements were made before, during, and after 10-s pulmonary arterial occlusion. Pulmonary arterial occlusion increased RV pressure and overall regional segment length. Length excursion became out of phase with RV pressure beats immediately after occlusion, and the strain patterns were different in the three regions at the peak of occlusion. The occlusion resulted in different alterations in regional monophasic action potential morphology, including reduction in monophasic action potential amplitude and duration by different amounts and early afterdepolarizations that were unevenly distributed in the monophasic action potential recordings. This was associated with dispersion of repolarization and recovery time. The combination of electromechanical events precipitated a variety of arrhythmias. Acute RV distension is proarrhythmic, possibly through a causal relationship among mechanically induced afterdepolarizations, dispersion (heterogeneity) of mechanical strain, and dispersion of electrical recovery. The relationship among the different wall motions, the dispersion of repolarization, and arrhythmia underscored mechanoelectric feedback as an important part of arrhythmogenesis in pulmonary embolism and commotio cordis.

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Section: Discussionsupporting

confidence: 91%

“…The different wall motions were enhanced by some interventions. Zwissler et al (36) found out-of-phase movement of inflow and outflow tracts of canine RV after acute pulmonary microembolization. Normalized end-diastolic SL increased in the inflow tract but simultaneously decreased in the outflow tract.…”

Section: Discussionmentioning

confidence: 99%

Stretch-induced regional mechanoelectric dispersion and arrhythmia in the right ventricle of anesthetized lambs

Chen

Penny

Greve

et al. 2004

American Journal of Physiology-Heart and Circulatory Physiology

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Monitoring der myokardialen Pumpfunktion — Methoden und ihr Stellenwert

Zwißler¹

1992

Der Kardiale Risikopatient in Der Operativen Medizin

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A novel technique to predict pulmonary capillary wedge pressure utilizing central venous pressure and tissue Doppler tricuspid/mitral annular velocities

et al. 2014

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Assessing left ventricular (LV) filling pressure (pulmonary capillary wedge pressure, PCWP) is an important aspect in the care of patients with heart failure (HF). Physicians rely on right ventricular (RV) filling pressures such as central venous pressure (CVP) to predict PCWP, assuming concordance between CVP and PCWP. However, the use of this method is limited because discordance between CVP and PCWP is observed. We hypothesized that PCWP can be reliably predicted by CVP corrected by the relationship between RV and LV function, provided by the ratio of tissue Doppler peak systolic velocity of tricuspid annulus (S(T)) to that of mitral annulus (S(M)) (corrected CVP:CVP·S(T)/S(M)). In 16 anesthetized closed-chest dogs, S T and S M were measured by transthoracic tissue Doppler echocardiography. PCWP was varied over a wide range (1.8-40.0 mmHg) under normal condition and various types of acute and chronic HF. A significantly stronger linear correlation was observed between CVP·S(T)/S(M) and PCWP (R2 = 0.78) than between CVP and PCWP (R2 = 0.22) (P < 0.01). Receiver-operating characteristic (ROC) analysis indicated that CVP·S(T)/S(M) >10.5 mmHg predicted PCWP >18 mmHg with 85% sensitivity and 88% specificity. Area under ROC curve for CVP·S T/S M to predict PCWP >18 mmHg was 0.93, which was significantly larger than that for CVP (0.66) (P < 0.01). Peripheral venous pressure (PVP) corrected by S T/S M (PVP·S(T)/S(M) also predicted PCWP reasonably well, suggesting that PVP·S(T)/S (M) may be a minimally invasive alternative to CVP·S(T)/S(M) In conclusion, our technique is potentially useful for the reliable prediction of PCWP in HF patients.

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Acute pulmonary microembolism induces different regional changes in preload and contraction pattern in canine right ventricle

Cited by 8 publications

References 13 publications

Stretch-induced regional mechanoelectric dispersion and arrhythmia in the right ventricle of anesthetized lambs

Stretch-induced regional mechanoelectric dispersion and arrhythmia in the right ventricle of anesthetized lambs

Monitoring der myokardialen Pumpfunktion — Methoden und ihr Stellenwert

A novel technique to predict pulmonary capillary wedge pressure utilizing central venous pressure and tissue Doppler tricuspid/mitral annular velocities

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