Überwachung der Myokardfunktion nach offenen Herzoperationen durch Messung des diastolischen und systolischen Druck-Zeit-Index

Seybold-Epting, W; Fenchel, G; Stunkat, R; Seboldt, H; He, Hoffmeister

doi:10.1055/s-0028-1096651

Cited by 2 publications

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“…-The endocardial viability ratio (EVR) obtained from the ratio of the DPTI (supply) to the TTI (demand) has been suggested to be a useful determinant for application of intra-aortic balloon counterpulsation by several authors (10)(11)(12)(13). -The endocardial viability ratio (EVR) obtained from the ratio of the DPTI (supply) to the TTI (demand) has been suggested to be a useful determinant for application of intra-aortic balloon counterpulsation by several authors (10)(11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

Examination of the validity of the DPTI as an estimate of myocardial oxygen supply with special reference to the DPTI/TTI ratio

et al. 1978

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The validity of the diastolic pressure time index (DPTI) as an estimate of myocardial 02 supply and tension time index (2TI) as an estimate of 02 demand has been examined in 10 closed-chest anesthetized dogs. We analyzed 158 steady states including maximal variation of hemodynamics and O 2 consumption. For each steady state 23 hemodynamic variables were calculated. Myocardial blood flow (MBF) was directly measured in the coronary sinus with a differential pressure catheter.Oxygen consumption (MVO2) was varied by application of catecholamines, atropine, negative and positive inotropic drugs and hypo-and hypervolemia. There was a close relationship between direct measurements of O 2 supply and 02 demand over a wide range of testing (r = 0.93), but there was no significant correlation between the ratio of DPTI/TI~I and the ratio of O2 supply/O2 demand (directly measured). With intact metabolic regulation of coronary blood flow there is no close correlation of mean diastolic aortic pressure to coronary blood flow (r = 0.45) over the entire tested range, which is one reason why the DPTI does not show a correlation to the direct measurement of O z supply (r = 0.34). The tension time index bears a close relationship to myocardial oxygen consumption only-under normal and moderate stimulation of inotropism (r = 0.96), but there is no significant correlation under high positive inotropic stimulation (r = 0.39). Our findings indicate that the ratio of DPTI/TTI should be interpreted with great care if it is generally used as an indicator of the adequacy of myocardial O2 supply. *) Supported by the Deutsche Forschungsgemeinschaft, SFB 89, Kardiologie, G6ttingen. T71

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Section: Discussionmentioning

confidence: 99%

Examination of the validity of the DPTI as an estimate of myocardial oxygen supply with special reference to the DPTI/TTI ratio

et al. 1978

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“…The DPTI/STTI ratio, also called endocardial viability ratio (EVR) and obtainable by a digital computer (EVR Datascope), is used as a clinical method for detecting subendocardial ischemia after open heart surgery and is regarded as a useful determinant for the application of intra-aortic balloon counterpulsation by several authors (2)(3)(4).…”

Section: Discussionmentioning

confidence: 99%

“…The ratio of the diastolic pressure time index (DPTI) to the systolic tension time index (STTI) is used in thoracic and cardiovascular surgery as an indicator for predicting subendocardial ischemia after open heart procedures (2)(3)(4). A digital computer has been introduced to calculate the ratio of DPTI/S2~rI and display continuously the result as the endocardial viability ratio (EVR = DPTI/S2~rI) (4).…”

Section: Sul'nmarymentioning

confidence: 99%

Prediction of myocardial blood flow by DPTI and prediction of the adequacy of myocardial O2 supply by the DPTI/STTI ratio under maximal coronary dilation

et al. 1979

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The DPTI/STTI ratio as an estimate of the myocardial 02 supply/demand ratio and the prediction of myocardial blood flow (MBF) by the diastolic pressure time index (DPTD and other indices have been examined in intact anesthetized dogs. We analyzed 89 steady states including maximal alterations of the variables determining DPTI and STI~I. Myocardial blood flow was directly measured in the coronary sinus with a differential pressure catheter. An experiments were carried out under maximal coronary dilation obtained by application of dipyridamol. Hemodynamics and MBF were varied by use of pressure loading, (3-stimulation and ~-blockade, hypo-and hypervolemia, electrical stimulation and hemodilution. Hemodynamic variations included clinically significant situations such as tachycardiac heart failure based on exhausted coronary vascular reserve and severe anemia. Parameters of sufficient myocardial 02 supply were coronary venous 02 saturation, precordial Ecg, hemodynamic evaluation of myocardial performance, result of autopsy and determination of the wet and dry weight ratio.All tested parameters show a poor correlation for prediction of MBF. Correlation coefficient for DPTI is r = 0.60. Using the primary data of Buckberg(1) we obtained similar results for the correlation of DPTI to subendocardial blood flow measured with microspheres (r = 0.65). The highest r (0.66) was found in our data for the difference between mean diastolic aortic pressure and mean left ventricular diastolic pressure without regard to diastolic duration. Therefore, in contrast to theoretical expectation, diastolic duration is not a practically important determinant of MBF. A number of DPTI/STrI ratios fell far below the critical values *) Supported by the Deutsche Forschungsgemeinschaft, SFB 89, Kardiologie, GSttingen. 811

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Überwachung der Myokardfunktion nach offenen Herzoperationen durch Messung des diastolischen und systolischen Druck-Zeit-Index

Cited by 2 publications

References 0 publications

Examination of the validity of the DPTI as an estimate of myocardial oxygen supply with special reference to the DPTI/TTI ratio

Examination of the validity of the DPTI as an estimate of myocardial oxygen supply with special reference to the DPTI/TTI ratio

Prediction of myocardial blood flow by DPTI and prediction of the adequacy of myocardial O2 supply by the DPTI/STTI ratio under maximal coronary dilation

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