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Recovery of Systolic and Diastolic Left Ventricular Function Early after Cardiopulmonary Bypass
- Source :
- Anesthesiology, Anesthesiology, 85(5), 1063-1075. Lippincott Williams and Wilkins
- Publication Year :
- 1996
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 1996.
-
Abstract
- Background Impairment of left ventricular function after cardiopulmonary bypass (CPB) is well recognized, but little is known about the time course of recovery of cardiac function early after separation from CPB. Therefore, recovery of left ventricular function was evaluated early after separation from CPB in patients undergoing coronary artery surgery. The authors tried to determine whether this recovery might be attributed to autoregulation of function by preload. Methods Left ventricular pressure was measured with fluid-filled catheters. Data were digitally recorded during increased pressure induced by elevating the legs. Transgastric short-axis echocardiographic views of the left ventricle were simultaneously recorded on videotape. Systolic function was evaluated with the slope (Ees, mmHg/ml) of the systolic pressure-volume relation. Diastolic function was evaluated with the chamber stiffness constant (Kc, ml-1) of the diastolic pressure-volume relation. Cardiac function was assessed before CPB, after termination of CPB, and 5, 10, and 15 min later. Two different separation procedures from CPB were compared: in protocol 1, left ventricular function was documented during the standard procedure (n = 24); in protocol 2, the heart was optimally filled 10 min before separation from CPB (n = 12). Results In protocol 1, Ees was 2.88 +/- 0.21 mmHg/ml (mean +/- SEM) and Kc was 0.012 +/- 0.001 ml-1 before CPB. Within 10 min after separation from CPB, Ees increased from 1.10 +/- 0.32 to 2.92 +/- 0.34 (P = 0.001) and Kc decreased from 0.022 +/- 0.002 to 0.011 +/- 0.001 (P = 0.001). The parameters remained stable thereafter. In protocol 2, Ees was 2.92 +/- 0.51 mmHg/ ml and Kc was 0.011 +/- 0.002 ml-1 before CPB. Depression of systolic and diastolic function was not observed in these patients. At time 0, Ees was 2.46 +/- 0.16 and Kc was 0.012 +/- 0.002. These values remained stable throughout the entire observation period. Conclusions Significant functional recovery was observed early after separation from CPB, which was suggestive of time-dependent changes in both systolic and diastolic left ventricular function induced by preload restoration.
- Subjects :
- Male
Cardiac function curve
medicine.medical_specialty
Time Factors
Systole
Diastole
Blood Pressure
law.invention
law
Internal medicine
medicine
Cardiopulmonary bypass
Humans
Ventricular Function
Anesthesia
Cardiopulmonary Bypass
business.industry
Hemodynamics
Stroke Volume
Stroke volume
Middle Aged
Coronary Vessels
Preload
surgical procedures, operative
Anesthesiology and Pain Medicine
Blood pressure
Echocardiography
Ventricular pressure
Cardiology
Female
business
Subjects
Details
- ISSN :
- 00033022
- Volume :
- 85
- Database :
- OpenAIRE
- Journal :
- Anesthesiology
- Accession number :
- edsair.doi.dedup.....2960356f13ddbf2c4afcd6b47ce1c281