Compensatory subendocardial hyperkinesis in the cat is abolished during coronary insufficiency outside an acutely ischaemic region.

OBJECTIVE: The aims were to determine (1) whether acute coronary occlusion provoked uniform hyperkinesis in remote non-ischaemic myocardium, and (2) how subsequent coronary stenosis affected such hyperkinesis. METHODS: Two pairs of ultrasonic crystals were placed in the anterior left ventricular midwall of nine pentobarbitone anaesthetised open chest cats. One pair (longitudinal) ran parallel to subendocardial fibres; the other pair (circumferential) was aligned with subepicardial and mid-myocardial fibres. Following circumflex coronary occlusion, subsequent hypoperfusion of the anterior wall was established by controlled constriction of a shunt line from the right subclavian artery to the left main coronary artery in two discrete steps. RESULTS: Following circumflex occlusion maximum systolic shortening of segments aligned to subendocardial fibres increased from 6.7(SEM 0.9)% to 11.5(1.4)% (p less than 0.001), whereas circumferential segment shortening was unchanged, at 12.2(0.8)% v 14.1(1.1)%. During mild shunt stenosis [delta P = 42(2) mm Hg] subendocardial tissue blood flow in the anterior wall decreased by 42(10)% (p less than 0.001), and longitudinal segment shortening decreased from 11.5(1.4)% to 6.9(1.1)% (p less than 0.001). Corresponding shortening of circumferential segments did not change. During severe shunt stenosis [delta P = 52(3) mm Hg] subendocardial tissue blood flow decreased further, and shortening of longitudinal segments approached zero value (p less than 0.001). CONCLUSIONS: Compensatory hyperkinesis of remote non-ischaemic myocardium following an acute coronary occlusion may depend mostly on augmented subendocardial contraction.

Intraluminal recording of cross-sectional blood velocity distribution of human ascending aorta by ultrasound Doppler technique.

A pulsed Doppler ultrasound technique was used for mapping two-dimensional blood velocity profiles in the human ascending aorta during open-heart surgery. An electronic position-sensitive device was constructed and linked to an intraluminal 10 MHz Doppler ultrasound probe. From a plane perpendicular to the central direction of blood flow, velocity mapping was performed covering the entire cross-section of the ascending aorta 6-7 cm above the valve. This method is based on a sequential sampling of velocity from continuously changing locations during a stable haemodynamic period; typically velocity points are recorded from 150-300 beats. Further processing transformed data to suit a previously developed velocity distribution model for normal blood flow in the human ascending aorta, based on multi-regression analyses. In this model, the time series of data from consecutive beats were computed into an average two-dimensional profile described through one cardiac cycle. This method allows high spatial resolution (1.5 mm), in addition to the high-frequency response (200 Hz) of the modified ultrasound Doppler meter. Together with the advantage of velocity directionality and minimal time interventions, this makes the method well suited for studies on normal flow conditions as well as flow velocity distribution distal to different heart valve prostheses.

Midazolam in combination with fentanyl/fluanisone and nitrous oxide as anaesthesia in rabbits--cardiovascular parameters.

When establishing a rabbit model for cardiovascular research in our laboratory we have used midazolam in combination with fentanyl/fluanisone (MFF) and nitrous oxide as anaesthesia. In this study we focused on the effect of the anaesthetic regimen on cardiovascular parameters during open-chest surgery in 12 rabbits. Rabbits were tranquillized by intramuscular injection of fentanyl/fluanisone (0.2 ml/kg of the drug that contained 10 mg/ml fentanyl and 0.2 mg/ml fluanisone). After an intraperitoneal injection of midazolam (4 mg/kg) and additional i.m. injection of fentanyl/fluanisone (0.1 ml/kg) the rabbits were tracheotomized and ventilated on a respirator delivering a gas mixture of 50% N2O, 47.5% O2, and 2.5% CO2. The femoral vein and artery were cannulated and then rabbits received a supply of MFF intravenously. The chest was opened by midline sternotomy and the left ventricle was instrumented with piezo-electric crystals for measurement of regional left ventricular function and with a pressure catheter to measure left ventricular pressure. Radiolabelled microspheres were used to assess cardiac output and left ventricular tissue blood flow. Blood gas analysis showed no difference in the values of pH, pCO2 and pO2 between the open-chest and the closed-chest states. Mean aortic pressure was 74 +/- 4 mmHg in the closed-chest state and 65 +/- 4 mmHg in the open-chest state. Tissue blood flow showed that the left ventricle was well perfused, and mean tissue blood flow values varied between 1.80 and 2.36 ml/min.g. We conclude that the anaesthetic regimen used is easy to control. It is well tolerated in rabbits and is suitable for studies on myocardial contraction in rabbits.

Intravenous lipid infusion results in myocardial lipid droplet accumulation combined with reduced myocardial performance in heparinized rabbits.

The question addressed in this study was whether a relation between myocardial lipid droplet accumulation and depressed myocardial function existed following intralipid infusion for 45 min in open chest, anaesthetized rabbits. One group of rabbits (n = 8) received intralipid infusion whereas a control group (n = 8) received sodium chloride. Local myocardial performance was obtained by sonomicrometry and the fractional volume of myocardial lipid droplets was measured by morphometric methods. The fractional volume of lipid droplets was 0.667 +/- 0.116% in the intralipid group compared with 0.318 +/- 0.080% in the control group (P < 0.03). Cardiac output and stroke volume fell 26% (P < 0.0001) and 34% (P < 0.0001), respectively, as a result of intralipid infusion. However, myocardial blood flow obtained by radiolabelled microspheres remained unchanged. Local myocardial function was reduced for both segments after intralipid infusion; maximal systolic shortening was reduced from 15.63 +/- 1.45 to 12.07 +/- 1.55% (P < 0.002) in the circumferential segment and from 9.46 +/- 1.17 to 7.40 +/- 0.53% (P < 0.05) in the longitudinal segment. The end-diastolic length of the circumferential segment was reduced by 3% (P < 0.05) after intralipid infusion. The reduced end-diastolic length of circumferential segments together with unchanged left ventricular end-diastolic pressure might indicate reduced left ventricular end-diastolic compliance. We conclude that acute intralipid infusion in rabbits results in myocardial lipid droplet accumulation and depressed local myocardial function.

Effects of endurance training on left ventricular performance: a study in anaesthetized rabbits.

Endurance training is known to increase ventricular performance during exercise and to decrease resting heart rate. The aim of this study was to evaluate a model for endurance training in rabbits and to study the effects of endurance training on local myocardial performance in the left ventricle during resting conditions. One group of rabbits underwent a 10-week exercise training programme. The rabbits trained 5 days a week on a treadmill. Training periods increased gradually from 15 min to 1 h with increments in speed from 0.5 to 1.2 km h-1. After the training programme the rabbits were anaesthetized and studied as acute open-chest preparations. A micro-tip pressure transducer was introduced via apex to the left ventricle and two pairs of ultrasonic crystals were implanted in the left anterior wall to measure segment lengths. One pair measured shortening in the circumferential direction whereas the other pair measured shortening in the longitudinal direction. Heart rate was lower in the trained group (n = 5), 172 +/- 9 beats min-1 (mean +/- SEM), compared with 235 +/- 19 beats min-1 in the control group (n = 8) (P < 0.02). Stroke volume, measured by radio-nuclidelabelled microspheres, was greater in the trained rabbits compared with controls (P < 0.03). Shortening in both segments was of similar magnitude for the trained and control groups. End-systolic pressure-length relations (ESPLR) obtained by occlusion of the descending aorta (balloon catheter) showed reduced slopes for longitudinal segments in the trained group compared with the control group (P < 0.05). We conclude that this endurance training programme in rabbits can be used to study myocardial effects of endurance training. Furthermore, the less steep slope of ESPLRs for the longitudinal segment in the trained animals might indicate a structural myocardial remodelling and increased contractile reserve that might be recruited during adrenergic stimulation in the trained group.

Three-dimensional cross-sectional velocity distribution in the ascending aorta in cardiac patients.

Knowledge of the distribution of velocities across the ascending aorta is important for measurements of cardiac output; for understanding the function of normal and diseased valves and for the evaluation of prosthetic valves. The aim of this study was to investigate, in detail, the spatial distribution of axial velocities in the human ascending aorta, covering a nearly complete cross-section of the lumen in a time continuous modus. During open-heart surgery, blood velocities in the ascending aorta were mapped in 10 patients. All patients had aortic valves with no significant clinical evidence of disease. Pulsed Doppler ultrasound technique was used to measure blood velocity using an intraluminal probe with a 1 mm, 10 MHz crystal connected to a position-sensitive device. The distribution of blood velocity in the aorta 6-8 cm above the valve was characterized by a skewed and irregular peak systolic flow, with maximum velocity posteriorly. There was a positive correlation (r=0.854, P<0.002) between the maximum skewness slope and the stroke volume. Significant retrograde flow was recorded in all patients in the left posterior part of aorta in late systole and early diastole. The rotation of the point of maximal velocity was anticlockwise in six patients, clockwise in three and alternating in one. The present study shows that there is a considerable individual variation in the velocity distribution in the ascending aorta, with no plane symmetric features, and that large sampling volumes are required for reliable estimates of mean velocity.

Comparison of transit-time and Doppler ultrasound methods for measurement of flow in aortocoronary bypass grafts during cardiac surgery.

To evaluate the accuracy of flow measurements in aortocoronary bypass grafts with the ultrasound transit-time method, an in vitro and in vivo comparison was carried out. The in vitro comparison with evaluation against both true flow and the ultrasound Doppler method, was carried out with a fresh saphenous vein mounted in a pulsatile flow rig. The two flow probes were placed on the graft 4-5 cm apart to avoid acoustic interference, and blood was pumped through the system at different flow rates. The comparison between the methods showed excellent agreement with a linear correlation coefficient of 0.996, and a mean error of -2.9 ml/min with limits of agreement +/- 13.1 ml/min (+/- 2 SD = 95% of measured differences between these limits). However, against true flow, both methods overestimated flow slightly with mean error 4.4 and 7.3 ml/min for the transit-time and Doppler, respectively. Both methods showed excellent correlation with true flow (correlation coefficient 0.998 for the transit-time and 0.997 for the Doppler method). The in vivo accuracy was evaluated by comparison of the two methods in 9 patients. The two probes were placed on the same saphenous vein grafts 4-5 cm apart, and a total of 34 measurements in 17 grafts were carried out including measurements at baseline and after papaverine injection. The correlation coefficient was 0.990 and linear regression analysis gave the equation: Transit-time flow = 1.00 x Doppler flow + 1.3. In terms of flow, the mean error was 1.5 ml with limits of agreement +/- 17.2 ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Non-uniform recovery of performance in stunned myocardium evaluated by two-dimensional sonomicrometry.

The objective of the present study was to assess the uniformity of contraction in reperfused myocardium. Regional function was measured by two pairs of piezo-electric crystals oriented in the circumferential and longitudinal axis of the left ventricular anterior midwall in 10 open-chest pentobarbitone-anaesthetized cats. The left anterior descending coronary artery was occluded for 10 min followed by 60 min of reperfusion. Myocardial blood flow was measured four times by radioactive labelled microspheres: at pre-occlusion, occlusion and after 30 and 60 min of reperfusion. There was a severe and transmural homogenous ischaemia during coronary occlusion. The recovery of ejection shortening was on average 76% at 30 min and 77% at 60 min of reperfusion in circumferential segments versus 25 and 44% in longitudinal segments (P < 0.05). Diastolic function was deranged in longitudinal segments; at 60 min of reperfusion the end diastolic pressure-length relation was still shifted rightwards in longitudinal segments, whereas it was normalized in circumferential segments. In conclusion, systolic and diastolic dysfunction in stunned myocardium were more severe in the longitudinal axis than in the circumferential axis of the feline heart. This indicates that stunning was more pronounced in longitudinally oriented sub-endocardial fibres which were reflected by the longitudinal segment, despite transmural homogenous ischaemia during coronary artery occlusion.

Velocity distribution in the ascending aorta in pigs during chronotropic and inotropic stimulation.

The influence of heart rate, stroke volume and myocardial contractility on temporal and spatial velocity distribution in the ascending aorta was investigated in 10 pigs. A pulsed Doppler ultrasound technique with intraluminal probe and a single crystal connected to a position-sensitive device was used to measure blood velocity. After baseline registration, the heart rate was increased in two discrete steps of 20 beats/min by right atrial pacing. Isoproterenol infusion was given to increase contractility. Finally, without isoproterenol, the heart rate was again raised to the values found during inotropic stimulation. The first three measuring situations did not differ haemodynamically, apart from increased heart rate and reduced stroke volume. Increased heart rates were not associated with significant change in the parameters for skewness of velocity distribution (peak systolic slope and ratio, maximum skewness slope and ratio). During inotropic stimulation the peak left ventricular dP/dt, aortic systolic pressure, cardiac output and stroke volume were greater than at comparable paced heart rate, and the peak systolic slope of velocity distribution was significantly increased. Velocity distribution in the ascending aorta thus was not altered by increased heart rate alone, whereas skewness of distribution was enhanced by increased inotropic drive of the myocardium and the concomitant central and peripheral vascular changes.