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.

[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).

[Changes of repolarization properties of the right ventricle in hypertensive left ventricular hypertrophy].

Repolarization properties of left ventricular (LV) myocardium change during its hypertrophy of various genesis. Aim of this work was to study repolarization of epicardial surface of the right ventricle (RV) in experimental model of LV hypertrophy caused by renovascular hypertension in rats. We registered 32 unipolar electrograms on the surface of cardiac ventricles and calculated duration of activation recovery intervals for assessment of repolarization. In hypertensive rats relative LV mass was 26% greater than in control rats, while relative mass of RV was similar in both groups. Length of activation recovery intervals in hypertension was 1.7 times greater than in control group on both LV and RV surfaces. Dispersion of activation recovery intervals did not differ significantly between groups. Thus in LV hypertrophy in rats caused by renovascular hypertension electrical remodeling of myocardium occurs not only in left but also in right ventricle.

Effects of ectopic pacing on repolarization of the chicken left ventricle.

Effects of ectopic pacing on left ventricular repolarization were studied in six anesthetized open-chest chickens. In each animal, unipolar electrograms were acquired from as many as 98 sites with 14 plunge needles (seven transmural locations between epicardium and endocardium in each needle). Activation-recovery intervals (ARIs), corrected to the cycle length, were used for estimating repolarization. At baseline, the nonuniform ARI distribution in the left ventricle resulted in the apicobasal differences being greater than the transmural gradient. Nonuniform ARI prolongation caused by ectopic pacing resulted in decreasing the transmural repolarization gradient and increasing the differences in the apex-to-base direction. The basal, but not apical transmural differences contributed to the total left ventricular transmural gradient. The total left ventricular apicobasal gradient was contributed by the apicobasal differences in mid-myocardial and subendocardial layers more than in subepicardial ones. Thus, in in situ chicken hearts, the transmural and apicobasal ARI gradients exist within the left ventricle with the shortest ARIs in the basal subepicardium and the longest ARIs in the subendocardium of the apical and middle parts of the left ventricle. Apicobasal compared to transmural heterogeneity of local repolarization properties contributes more to the total left ventricular repolarization gradient.

Changed duration of ventricle repolarization in dog heart under conditions of increased preload.

The duration of repolarization of subendocardial, intramural, and epicardial layers of dog ventricles was studied under conditions of volume overload of the heart in situ. Increased preload was modeled by rapid intravenous infusion of saline and rheopolygluquine. The activation-recovery interval was measured by flexible intramural electrodes inserted into the right and left ventricles. The level of preload was evaluated by the increase in left-ventricular end-diastolic pressure. The increase in preload from 11+/-6 to 26+/-10 mm Hg led to a significant (p<0.05) prolongation of the activation-recovery interval in the subepicardial layers of apex, all layers of the lateral wall, and subepicardial and intramural layers of the base of the left ventricle and in subendocardial layers of the apex and base of the right ventricle. Further elevation of the end-diastolic pressure to 34+/-11 mm Hg led to shortening of the activation-recovery interval (p<0.05) in the subepicardial layers of the apex and lateral wall of the left ventricle and in the subepicardial layers of right-ventricular base and left-ventricular lateral wall. Hence, different areas of the myocardium differently react to volume overload of the heart. Changes in repolarization length in response to preload increase are biphasic.

[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.

[Cardiac electric field at the period of depolarization and repolarization of the frog heart ventricle].

Multichannel mapping of electrical field on heart ventricle epicardium and the body surface in frogs Rana esculenta and Rana temporaria was performed at periods of the ventricular myocardium depolarization and repolarization. The zone of the epicardium early depolarization is located on epicardium of the ventricle base posterior wall, while the late depolarization zone--on its apex and on the base anterior wall. The total vector of sequence of the ventricle epicardium depolarization is directed from the base to the apex. The zone of the early repolarization is located in the apical area, while that of the late one--in the area of the base. On the frog body surface the cardioelectric field with the cranial zone of negative and the caudal zone of positive potentials is formed before the appearance of the QRS complex on ECG. At the period of the heart ventricle repolarization the zone of the cardioelectric field negative potentials is located in the cranial, while that of the positive ones--in the body surface caudal parts. The cardioelectric field on the frog body surface at the periods of depolarization and repolarization of the ventricle myocardium reflects adequately the projection of sequence of involvement with excitation and of distribution of potentials on epicardium.

[Correlation in the of the process of cardiac ventricle intramural depolarization and distribution of cardioelectric field potentials of the dog Canis familiaris].

Based on a multichannel synchronous mapping of heart electric potentials, the sequence in time of the ventricle myocardium depolarization was compared with dynamics of distribution of cardioelectric potentials on the body surface in a dog. The cardioelectric field on the dog body surface at the period of the initial ventricular activity has been shown to be characterized by the presence of two inversions of the mutual disposition of areas of positive and negative potentials. Contribution to formation of distribution of the cardioelectric potentials on the body surface at each moment of the period of initial ventricular activity was made by all myocardial layers involved by excitation.

Mechanism of electrocardiographic T-wave flattening in diabetes mellitus: experimental and simulation study.

In the present study we investigated the contribution of ventricular repolarization time (RT) dispersion (the maximal difference in RT) and RT gradients (the differences in RT in apicobasal, anteroposterior and interventricular directions) to T-wave flattening in a setting of experimental diabetes mellitus. In 9 healthy and 11 diabetic (alloxan model) open-chest rabbits, we measured RT in ventricular epicardial electrograms. To specify the contributions of apicobasal, interventricular and anteroposterior RT gradients and RT dispersion to the body surface potentials we determined T-wave voltage differences between modified upper- and lower-chest precordial leads (T-wave amplitude dispersions, TWAD). Expression of RT gradients and RT dispersion in the correspondent TWAD parameters was studied by computer simulations. Diabetic rabbits demonstrated flattened T-waves in precordial leads associated with increased anteroposterior and decreased apicobasal RT gradients (P<0.05) due to RT prolongation at the apex. For diabetics, simulations predicted the preserved T-vector length and altered sagittal and longitudinal TWAD proven by experimental measurements. T-wave flattening in the diabetic rabbits was not due to changes in RT dispersion, but reflected the redistributed ventricular repolarization pattern with prolonged apical repolarization resulting in increased anteroposterior and decreased apicobasal RT gradients.

[Experimental study of successive range of excitation of the heart ventricles]. / Eksperimental'noe izuchenie posledovatel'nosti okhvata vozbuzhdeniem zheludochkov serdtsa.

The succession of excitation spreading about the cardiac ventricles was studied in 28 dogs using the intramural multipolar technique. The primary foci of excitation were found in the zones of the subendocardium on the borderline between the lower and middle portions of the left side of the ventricular septum, and under the base of the anterior papillary muscle on the right side of the ventricular septum. The excitation of the interventricular septum throughout its thickness occurs first of all in the anterior part of its mid-portion where the depolarization waves moves exclusively from left to right. Lastly the posterior lateral subendocardial layers of the bases of the free walls and the upper portion of the ventricular septum are depolarized. In some parts of the interventricular septum and of the left free wall the excitation wave first reaches the zones located deeply under the endocardium, then spreads towards the endo- and epicardium, changing its direction several times.

[The process of heart ventricle depolarization and the formation of an electrocardiographic QRS complex in the frog]. / Protsess depoliarizatsii zheludochka serdtsa i formirovanie élektrokardiograficheskogo kompleksa QRS u liagushki.

Using intramural multipolar electrode technique, the pattern of propagation of the heart ventricle depolarization was studied in the frog Rana temporaria. The depolarization wave from the middle part of subendocardial layers was shown to spread to the apex and base of the heart and, simultaneously, to the epicardium. The ECG complexes are formed by the electrical activity of the endocardial, intramural and epicardial layers.

[Chromotopography of ventricular depolarization in northern reindeer]. / Khronotopografiia depoliarizatsii zheludochkov serdtsa severnykh olenei.

With the aid of intramural multipolar technique, the sequence of the heart ventricles depolarization was studied in deer. Electric potentials were led from 1500-1700 points in the myocardium. Primary foci of excitation were revealed in the subendocardium of the caudal and cranial areas of the middle third of left and cranial portions of the upper third of right side of the interventricle partition. Within 5-10 msec. the ventricles subendocardium is wholly involved into the wave of depolarization. For 10-20 msec., the main lot of free walls, the central and upper portions of the partition, are excited. This period is characterized by spreading of the depolarization wave from numerous foci of excitation in all directions. Last the upper portions of the pulmonary artery output cone (40-45 msec.) and portions of the interventricle partition adjacent to the ventricles basis (45-50 msec.), become excited.

[Sequence of the spread of excitation in bird heart ventricles]. / Posledovatel'nost' rasprostraneniia vozbuzhdeniia v zheludochkakh serdtsa ptits.

Intramural multipolar technique revealed primary sites of excitation in the subendocardium of central areas of border line of the apical and middle thirds of the bird heart septum. From the zone of primary depolarization the excitation wave spread on the subendocardium of ventricles. A number of sites of negativity were observed over the epicardium. The main mass of myocardium of free walls and the lower two thirds of the septum are activated by means of myocardium of free walls and the lower two thirds of the septum are activated by means of multifocal depolarization. The base third of the septum is the last to be activated. These features of the excitation of bird myocardium can be accounted for by the special character of distribution of the Purkinje fibers in the muscles of myocardium ventricles.

[The dynamics of the form of the extracellular potentials and of the process of depolarization wave spreading in the intramural layers of the myocardium in dogs with experimental ischemia]. / Dinamika formy vnekletochnykh potentsialov i protsessa rasprostraneniia volny depoliarizatsii v intramural'nykh sloiakh miokarda sobaki pri éksperimental'noi ishemii.

The reversal of directions and local delays or accelerations of the extracellular potentials evolution occurred at arrival of the depolarization wave after coronary occlusion in dogs. General patterns of directions of the activation spread changed relatively little when compared to normal. Apparently, in spite of the ligation of the left anterior descending coronary artery, ischemia was not achieved. There was some additional blood supply to the ischemic myocardium from deep collateral arterial branches. Therefore, the observed abnormalities of electrical potentials and the reversals of the depolarization wave direction only took place in local small zones of ischemic myocardium.

[Sequential pattern of the propagation of excitation in the heart of the sheep Ovis brachyurae]. / Posledovatel'nost' rasprostraneniia vozbuzhdeniia v serdtse ovtsy Ovis brachyurae.

With the aid of intramural multipolar technique, the earliest focus of the depolarization is revealed in the myocard thickness of the cranioventral region of the right atrium of the sheep. From there the depolarization wave with a saw-edged front is spread along the thickness of the atria. The chronotopography of the intramural activation wave front shows a more complicated picture of the atrial excitation than a smiply radial one. Apparently it is connected with the presence of the atrial conduction system. The main mass of myocardium of free ventricle walls and the lower two thirds of the septum are activated by means of multifocal depolarization. The base third of the septum is the last to be activated. These features of excitation of the ovine ventricle myocardium can be explained by special character of distribution of the Purkinje fibers in myocardium ventricles.