Physio-pharmacological evaluation of myocardial performance: an integrative approach

Abstract

sion have altered out of all recognition compared to the Despite major advances in the understanding of carapproaches of 40-50 years ago. diovascular physiology and pathophysiology and the deWithin this context, the questions that are considered in velopment of new therapies in the 20th century, carthis article are: How should myocardial performance best diovascular disease is projected to become the leading be assessed? What are the advantages and disadvantages of overall cause of mortality worldwide within the next currently used methodologies? How far can and should couple of decades [1]. In the western world, an increasing reductionism be pursued? What is the relevance of animal proportion of older people in the population accounts for models? The implicit pre-requisite in answering these the lack of reduction in the absolute number of carquestions is that information obtained using any particular diovascular deaths, whereas in developing countries, part approach should, ultimately, be of some relevance to of the reason is the adoption of ''western'' lifestyles and human cardiovascular function or dysfunction. their accompanying coronary risk factors as socioeconomic Although we focus in this counterpoint article on the in status gradually improves and mortality from infectious vitro assessment of myocardial contractile behaviour, it is and other diseases of early life decrease. There remain clear that many other aspects of cardiac function as well as significant gaps in our understanding of many aspects of that of other organs will be relevant to the understanding cardiovascular diseases and the contribution of risk factors of cardiovascular disorders. Within the heart, coronary such as smoking, hypercholesterolaemia, hypertension and vascular function, endothelial function, the influence of diabetes. In addition, increasing numbers of patients who blood cells, neural control, the release of circulating survive ischaemic cardiac disorders develop heart failure.hormones, such as natriuretic peptides, locally active Traditionally, the focus of research into cardiovascular paracrine and autocrine substances, and the properties of disease was the heart and myocardium, but in the last the extracellular matrix may all be relevant to contractile several decades, the importance of the vasculature and of function as well as other aspects, such as energetics, other body systems has been better appreciated. The field growth, hypertrophy and so on. With respect to the of vascular biology has blossomed. Traditionally, invescontractile process itself, and its regulation, a full undertigators focused on mechanical function. However, in the standing requires information about excitation-contraction last several decades, investigative approaches have coupling, signal transduction, myofilament mechanisms, broadened dramatically, ranging from molecular and celenergetics and molecular mechanisms, to name but a few lular biology and physiology, to in vitro and in vivo relevant aspects. studies in animal models of disease, to st...

Effects of bupivacaine, levobupivacaine and ropivacaine on myocardial relaxation

“…The isolated papillary muscle provides a precise model to assess the mechanical properties of muscle where it is possible to accurately measure (and control) force and length in a multicellular preparation with relatively simple geometry. 29 We observed that LAAs induce a negative lusitropic effect in isotonic and isometric conditions ( Figure 3). Because isotonic relaxation strongly depends on calcium reuptake by the SR, 23 this result suggests an inhibitory effect of LAAs on SR function.…”

Das isolierte Kaninchenherz: ein Vergleich zwischen fünf Varianten

“…In diesem Zusammenhang soll auch erwähnt werden, dass es durch den intraventrikulären Ballon zu einer Störung des endokardialen Endothels und hierüber zu einer Verschlechterung der globalen Ventrikelfunktion kommen kann. Dieser Effekt scheint jedoch nicht besonders ausgeprägt zu sein [26]. Letztlich könnte auch die im Folgenden angesprochene Ödembildung über eine Erhöhung der internen Arbeit zu dem verminderten Wirkungsgrad beitragen.…”

“…Gegenüber anderen isolierten Präparatio-nen ließen sich zusätzlich die Interaktionen zwischen koronarvaskulären und ventrikulären Eigenschaften untersuchen. Letztlich kann bei diesem isolierten Modell auch der Einfluss des Endothels auf die myokardiale Funktion untersucht werden, da sich hier die Endothelzellen unter In-situ-Bedingungen physiologischen Stimuli unterwerfen lassen [26].Dieses experimentelle Modell hat in mehrfach modifizierter Form seinen festen Platz in der medizinischen Forschung gefunden. Daher sind Eigenschaften einzelner Varianten gut bekannt.…”