Functioning of the Human Heart in the Pron-Position.

Aim      To study intracardiac hemodynamics in healthy men in supine and prone positions.Material and methods  This echocardiography study included 14 apparently healthy men at a mean age of 38 years.Results In a prone position, the heart configuration and location in the chest changed, the heart rate increased by 7.3 %, and the transaortic flow velocity decreased by 13.7 %. Also, early and late right ventricular diastolic filling velocities and the pulmonary artery flow velocity were increased by 31.7, 11.4, and 5.6 %, respectively. In the intact tricuspid valve, the velocity and regurgitation pressure gradient were reduced by 7 % and 14.2 %, respectively.Conclusion      In a prone position, spatial changes in the location of the heart and its structures influence velocities of intracardiac blood flow, which may initiate the development of heart failure if the prone position is long-lasting.

Effect of Sex on Structural and Morphological Parameters of Rat Heart under Conditions of Combined Exposure to Hypokinesia and Cold.

We studied the combined effect of hypokinesia and external cooling on structural and morphological changes in the ventricular myocardium and parameters of homeostasis of the blood system in male and female WKY (normotensive) and SHR (hypertensive) rats. Simultaneous exposure to hypokinesia and cold caused destructive processes in the myocardium and high dynamics of heart remodeling with diverse structural and morphological changes in the left ventricle in rats of both sexes. The thickness of the left ventricular wall most rapidly decreased in male hypertensive SHR rats. The thickness of the wall of the right ventricle significantly increased in male and female rats of both strains. In WKY and SHR females, structural transformations in the heart were less pronounced than in males. The key role in different degree of morphological remodeling of the myocardium in male and female probably belongs to sex hormones.

Changes in Total Cholesterol and Heart Rate in Normotensive and Hypertensive Rats under Combined Influence of Cold Exposure and Hypokinesia.

We studied the effect of hypokinesia alone and in combination with cold exposure on HR and total cholesterol content in the blood serum of Wistar, WKY, and SHR rats. Irrespectively of the season, hypokinesia was associated with a decrease in HR, which is probably a result of reduced body needs due to deceleration of metabolic processes. A significant increase in total cholesterol was found under conditions of cold exposure combined with hypokinesia, which indicates qualitative structural rearrangement of energy metabolism under the influence of environmental factors. In winter, the increase in total cholesterol concentration was more pronounced (by 51.5%) in the group of hypertensive animals. Presumably, the increase in the serum concentration of total cholesterol under conditions of hypokinesia and cold exposure is a predictor of structural changes in the heart.

Combined Effects of Hypokinesia and Ambient Temperature on Heart Remodeling in Normotensive and Hypertensive Rats.

We studied the effect of hypokinesia combined with cold exposure on morphological parameters of the heart in Wistar-Kyoto rats and rats with spontaneous genetically determined hypertension (SHR). The pathological processes developing in the heart of white laboratory rats significantly affected cardiac function and manifested in the deterioration of the morphological structure of the heart: reduction of heart weight, thinning of the free wall of the left ventricle. These changes indicate transition to a lower energy level of functioning. At the same time, hypertrophy of the right free wall develops in both rat lines. Combined effect of hypokinesia and cold is probably a factor indirectly promoting the development of pulmonary heart.

Irregular Ventricular Tachycardia as a Mechanism of Stabilization of Mechanoelectrical Processes in Canine Heart under Conditions of Antiorthostatic Hypokinesia.

We studied electrophysiological mechanisms of ventricular arrhythmias in dogs (n=7) under conditions of antiorthostatic hypokinesia (head-down tilt 45°). Abnormal transmural heterogeneity of repolarization in the base and apex of the left ventricle and increased dispersion of myocardial repolarization were revealed. By minute 30 of antiorthostatic hypokinesia, an increase in the duration of repolarization was revealed after a period of ventricular arrhythmia in all segments and regions of heart ventricles, which was accompanied by impairment of the pumping function of the heart. A hypothesis on the physiological role of ventricular tachycardia as a mechanism of electromechanical homeostatic stabilization in the heart was proposed. The obtained results suggest that under conditions of antiorthostatic hypokinesia, canine heart after a paroxysm of irregular ventricular tachycardia becomes more resistant to arrhythmia.

Isoprenaline Impairs Contractile Function of Ventricular Myocardium in Common Frog (Rana temporaria).

The contractile function of the heart was studied in adult frogs Rana temporaria under the influence of a toxic dose of isoprenaline under conditions of natural sinoatrial rhythm and during heart pacing. The dynamics of ventricular pressure was recorded with a Prucka MacLab 2000 instrument via a catheter introduced into the ventricle through the ventricular wall. Reduced (p<0.05) parameters of the pump function (HR, maximum ventricular systolic pressure, isovolumic indices dP/dtmax and dP/dtmin) and lengthening of QRS complex and QT interval on ECG attested to impairment of contractile function and electrical processes after exposure to isoprenaline. Electrical stimulation of the right atrium improved myocardial contractility and ECG parameters after the administration of isoprenaline.

Pumping Function of Heart Ventricles in Different Mammalian Species under Conditions of Electrical Cardiostimulation.

Pumping function of the heart ventricles under conditions of electrical stimulation was examined in adult dogs and rabbits. Pacing induced different changes in intracardiac hemodynamics manifested in impairment of pumping function of the right ventricle, which is largely determined by the functional state of the left ventricle. Initially high HR in rabbits more deeply limited functional reserve of the myocardium in response to electrical stimulus and was accompanied by more pronounced disturbances of pumping function of both ventricles.

Repolarization of Heart Ventricles in Dogs during Recovery after Antiorthostatic Hypokinesia.

Repolarization properties of ventricular myocardium were studied in anesthetized adult dogs of both sexes subjected to antiorthostatic hypokinesia (head-down tilt at 45° and 60° to the horizontal) and during recovery period (horizontal position for 15 min). The time of repolarization of ventricular myocardium during recovery surpassed the initial value, which represents an adaptive response of the heart to antiorthostasis.

[Effect of the heart electric stimulation on repolarization of fish and amphibian ventricular myocardium].

By the method of synchronous multielectrode cartography (24-unipolar leads), distribution of durations and time of end of repolarization were studied on ventricular epicardium of pikes (Esox lucius) and frogs (Rana esculenta) and in ventricular intramural layers of toads (Bufo bufo) at the ectopic heart excitation. The time of arrival of the excitation wave and of the end of repolarization in each lead was determined from the minimum of time derivative of potential at the period of the QRS complex and by minimum of the T wave, respectively. It has been established that at the ventricle electrostimulation, alongside with deceleration and a change of sequence of the myocardium activation, there occurs redistribution of local repolarization durations: in areas of late activation the repolarization being longer than in zones of early activation (p < 0.05). At stimulation, the apicobasal gradient of repolarization is predominantly changed due to electrophysiological processes in the apical areas. In all studied species. at ectopical excitation of the heart ventricle the sequence of its repolarization repeats the depolarization sequence due to delay of activation (in fish) and redistribution of repolarization durations (in amphibians).

[Effect of ectopic excitation on pump function of the hen and dog right heart ventricle].

The pump function of the right heart ventricle has been studied in anesthetized dogs and hens at sinus rhythm, supraventricular rhythm, and subepicardial ectopic excitation of base and apex of the right and left ventricles. Dynamics of the ventricle intracavital pressure was recorded by transmural catheterization. The pump function of the right ventricle in hen (as compared with sinus rhythm) retained to the greater degree at stimulation of the left ventricle apex and deteriorated significantly at stimulation of the right ventricle, whereas in dog (as compared with supraventricular rhythm) it retained to the greater degree at stimulation of the left ventricle base and deteriorated at stimulation of the right ventricle apex. Changes of the pump function of the right heart ventricle at ectopic ventricle stimulation are similar in birds and mammals. Differences in changes of dog and hen pump functions under effect of location of the ectopic excitation seem to be due to morphofunctional peculiarities of heart ventricles.

[Repolarization of canine ventricular myocardium under the supraventricular rhythm].

The ventricular myocardium is characterized by heterogeneity of activation-recovery interval durations. The transmural ARI gradients are present in the right ventricular apex (ARIs monotonically decreased as one moved from the endocardium to the epicardium), and in the left ventricular base (repolarization in the subepicardial layers was significantly shorter than that in the midmyo cardial layers whereas subendocardial ARIs did not differ from the others). The repolarization pattern of these myocardial regions is governed by the distribution of ARIs. In the apical left ventricular and basal right ventricular areas, no significant transmural differences in the repolarization durations were found. The repolarization pattern of these myocardial regions is governed by the activation sequence. In the right ventricle, ARIs were significantly longer at the base and shorter at the apex. In contrast, in the left ventricle, the apical ARIs were prolonged whereas the basal ARIs were abbreviated. The apex-to-base sequence of myocardial repolarization seems to depend on apex-to-base gradient of activation-recovery intervals durations.

[Effect of ectopic excitation on the ventricular pump function in chicken].

The pump function of the heart ventricles was studied in chest-open anaesthetized adult female chickens under sinus rhythm and ectopic excitation of different localization. The intraventricular pressure in the right and left heart ventricles was measured by insertion of catheters through the ventricular free walls. Maximum systolic pressure, end-diastolic pressure, contractility (dP/dtmax) and relaxation (dP/dtmin) of both heart ventricles, and duration of the asynchronous contraction time of the left ventricle were analyzed. It was revealed that reduction of the pump function of the left ventricle tends to be greater under right ventricular ectopic excitation compared with left ventricular one. In comparison with the sinus rhythm, the pump function of the right ventricle was preserved to a greater extent under stimulation of the left ventricular apex and was significantly impaired under right ventricular ectopic excitation. Relaxation of both heart ventricles was more susceptible to ventricular ectopic excitation than contractility, and was more vulnerable in the right ventricle than in the left one. The direction of changes of the pump function of the heart ventricles in chickens under ventricular ectopic excitation was similar to changes of the pump function of mammalian hearts.

[Ventricular pump function under ectopic excitation of the frog heart].

The ventricular pump function under ectopic excitation of the heart was studied in decapitated and pithed adult frogs Rana temporaria (n = 21) at 18-19 degrees C. The intraventricular pressure was recorded with a catheter via ventricular wall. During pacing of the ventricular base and apex, the systolic pressure decreased (6.1 +/- 4.5 mm Hg and 8.9 +/- 5.0 mm Hg, respectively) as compared to the supraventricular rhythm (8.9 +/- 5.0 mm Hg, p < 0.05). The end-diastolic pressure decreased insignificantly both under basal and apical pacing. The systolic rate of pressure rise during dP/dtmax decreased under ventricular pacing, especially during pacing of the ventricular apex, as compared to the supraventricular rhythm (14.4 +/- 6/9 mm Hg/s and 22.1 +/- 11.2 mm Hg/s, respectively, p < 0.003). The isovolumetric relaxation (dP/dtmin) slowed during apical pacing as compared to the supraventricular rhythm (-25.1 +/- 13.6 and -35.6 +/- 18.3 mm Hg/s, respectively, p < 0.03). Ectopic excitation of the ventricular base and apex resulted in increase of the QRS duration (93 +/- 33 ms and 81 +/- 30 ms, respectively) as compared to the supraventricular rhythm (63 +/- 13 ms, p < 0.05). Thus, pacing of different ventricular areas ventricular myocardium with the ventricular pump function being reduced more obviously during the apical pacing compared to the pacing of ventricular base.

Repolarization of ventricular myocardium in atrioventricular electrical stimulation of the heart in dogs.

The duration of ventricular myocardium excitation increases during atrioventricular stimulation of dog heart and the sequence of depolarization of the right and left ventricles is desynchronized. Significant shortening of the activation-recovery interval in the intramural and subendocardial layers of the left ventricular base leads to modification of the repolarization sequence in this area and to an increase of total dispersion of activation-recovery intervals in the cardiac ventricles, as a result of which repolarization sequence starts partially repeating the depolarization sequence.