Optimization of the method of x-ray contrast left ventriculography

The authors propose their modification of the method of left ventriculography (VG) (substitution of direct VG for iv VG with an injection of a contrast medium into the right atrial chamber in combination with continuous monitoring of pressure in the LV chamber). Altogether 23 patients with a doubtful diagnosis of CHD were investigated by coronography, direct VG and iv biventriculography. All images of the left ventricle were subjected to computerized multiframe analysis. A conclusion is that the modified method is more preferable than direct VG.     

Effect of contrast ventriculography of the left ventricle on coronary hemodynamics in patients with ischemic heart disease]

The effect of left ventricular (LV) contrast ventriculography (VG) on the state of intracardiac hemodynamics during the administration of a contrast medium and 30-40 sec. after it was investigated in 48 CHD patients. It followed retrograde catheterization of the left ventricle by a parallel use of two catheters that permitted recording intraventricular pressure directly during LV VG. The performance of left VG with 76% urografin administered in a dose of 0.6-0.8 ml/kg with the rate of 13-15 ml/s produced no significant change in the state of intracardiac hemodynamics, relaxation and pumping function of the LV in the course of the first three contrasted cardiocycles. Transitory disorder of hemodynamics observed in the patients after contrast VG was restored by itself in 15-20 min.     

Heterogeneity of the myocardium. Function of the left and right ventricle under normal and pathological conditions

A number of important differences can be found between the left ventricle (LV) and right ventricle (RV) of the heart under physiological conditions. In anatomy, the most important is probably the architecture of the atrioventricular valve and its annulus. The LV has a mitral valve (with two cusps) and a firm annulus, while the RV has a tricuspid valve with a greater total area, but relatively small cuspid areas, and an elastic annulus. The difference in the blood supply is important. Owing to high intramural pressure, the coronary flow in the wall of the LV occurs only during the diastole; in the RV it is limited only in the presence of a significant increase in intracavitary pressure. The LV myocardium is functionally "accustomed" to short-term marked changes in the systolic load (in extreme static exercise the arterial pressure rises for a short time to three times the normal value), while the RV is adapted to changes in the diastolic load (marked filling changes associated with deep breathing, for instance). The difference in the response to a long-term volume load is difficult to evaluate: between a defect of the interatrial septum and aortic insufficiency there are too many differences. A long-term pressure load seems to be tolerated better by the right ventricle: patients with severe pulmonary stenosis and a pressure six times higher than the physiological value have lived 25 years and patients with isolated corrected L-transposition of the great arteries can reach 35 years without any signs of impaired RV function.(ABSTRACT TRUNCATED AT 250 WORDS)     

Unloading-induced remodeling in the normal and hypertrophic left ventricle

To date, no study has assessed the degree of similarity between left ventricular (LV) reverse remodeling and atrophic remodeling. Stable LV hypertrophy was induced by creation of an arteriovenous fistula (AVF) in Lewis rats (32 days). LV unloading was induced by heterotopic transplantation of normal (NL-HT) and/or hypertrophic (AVF-HT) hearts (7 days). We compared indexes of remodeling in AVF, NL-HT, and AVF-HT groups with those of normal controls. LV unloading induced decreases in cardiomyocyte size in NL-HT and AVF-HT hearts. NL-HT and AVF-HT LV were both characterized by relative increases in collagen concentration that were largely a reflection of decreases in myocyte volume. NL-HT and AVF-HT LV were associated with similar increases in matrix metalloproteinase (MMP-2 and -9) zymographic activity, without change in the abundance of the tissue inhibitors of the MMPs. In contrast, AVF-HT, but not NL-HT, was associated with a dramatic increase in collagen cross-linking. Our findings suggest an overall similarity in the response of the normal and hypertrophic LV to surgical unloading. However, the dramatic increase in collagen cross-linking after just 1 wk of unloading suggests a potential difference in the dynamics of collagen metabolism between the two models. Further studies will be required to determine the precise molecular mechanisms responsible for these differences in extracellular matrix regulation. However, with respect to these and related issues, heterotopic transplantation of hypertrophied hearts will be a useful small animal model for defining mechanisms of myocyte-matrix interactions during decreased loading conditions.     

The motion of the left ventricle. I

The complex arrangement of the muscle fibers in the ventricular wall and the nonsymmetric contraction and expansion of the ventricle preclude the writing of a differential equation of motion for the ventricle as a whole. We can, however, describe the motion of the ventricle by describing the motion of the dimensional parameters length and diameter; the radius, circumference, cross-sectional area, and volume following naturally from these. The ventricle is assumed to be an ellipsoid of revolution and the dimensional parameters to be periodic functions of time. Each of the parameters is expressed as a Fourier series.     

The influence of inflow boundary conditions on intra left ventricle flow predictions

The combination of computational fluid dynamics (CFD) and magnetic resonance imaging (MRI) offers a promising tool that enables the prediction of blood flow patterns in subject-specific cardiovascular models. The influence of the model geometry on the accuracy of the simulation is well recognized. This paper addresses the impact of different boundary conditions on subject-specific simulations of left ventricular (LV) flow. A novel hybrid method for prescribing effective inflow boundary conditions in the mitral valve plane has been developed. The detailed quantitative results highlight the strengths as well as the potential pitfalls of the approach.     

Dynamic stiffness profiles in the left ventricle.

Diastolic pressure-volume (P-V) curves were calculated on a beat-to-beat basis in the open-chest, pentobarbital-anesthetized dog, using the technique of direct transmitral flow measurement previously described. P-V curves were constructed and the slope (dP/dV) was plotted vs. pressure and time. dP/dV was used as an index of stiffness in each heart and its instantaneous changes with time were followed throughout the diastolic period. The end-diastolic P-V relation based on points from successive cycles during volume loading was found to be exponential. In contrast, the instantaneous P-V relation during any one diastolic period was not exponential. That is, the dynamic dP/dV vs. pressure plot was nonlinear. In the normal heart, stiffness was characterized in early diastole by a negative dP/dV as the ventricle continued to relax, and then frequently decreased prior to a second stiffness rise with atrial augmentation. These findings can be explained by a model containing an element whose deformation is rate dependent, i.e., a parallel viscous element. Stiffness profiles in mitral stenosis where dynamic effects are minimized substantiate this conclusion.     

A model of the structural and functional development of the normal human fetal left ventricle based on a global growth law

The purpose of this research is to study the growth of the normal human left ventricle (LV) during the fetal period from 14 to 40 weeks of gestation. A new constitutive law for the active myocardium describing the mechanical properties of the active muscle during the whole cardiac cycle has been proposed. The LV model is a thick-walled, incompressible, hyperelastic cylinder, with families of helicoidal fibers running on cylindrical surfaces [1]. Based on the works of Lin and Taber [2] done on the embryonic chick heart, we use for the human fetal heart a growth law in which the growth rate depends on the wall stresses. The parameters of the growth law are adapted to agree with sizes and volumes inferred from two dimensional ultrasound measurements performed on 18 human fetuses.Then calculations are performed to extrapolate the cardiac performance during normal growth of the fetal LV. The results presented support the idea that a growth law in which the growth rate depends linearly on the mean wall stresses averaged through the space and during whole cardiac cycle, is adapted to the normal human fetal LV development.     

Two functional Na+/K(+)-ATPase isoforms in the left ventricle of guinea pig heart.

Guinea pig left ventricular muscle contains two distinct molecular forms of the Na+/K(+)-ATPase catalytic alpha subunit. Sarcolemmal vesicles highly enriched in Na+/K(+)-ATPase were isolated by a new procedure that yielded specific activities of 60-100 mumol Pi.h-1.mg-1. SDS/PAGE of isolated sarcolemma after reduction and alkylation of the sulfhydryl groups and identification on immunoblots with specific anti-(alpha subunit) antibodies indicated the presence of two major polypeptides of 100 kDa and 103 kDa, respectively. The two alpha subunits were functional: the dose/response curves of Na+/K(+)-ATPase activity with ouabain, dihydroouabain and digitoxigenin were biphasic, revealing the presence of high-affinity [concentration of drug causing 50% inhibition (IC50) = 10 nM] and low-affinity (IC50 = 2 microM) forms with proportional contributions of 55% and 45%, respectively. The involvement of the high-affinity form in the positive inotropic effect of digitalis and of the low-affinity sites in both inotropy and toxicity are consistent with the literature data on rodents.     

The motion of the left ventricle: II

We use the dimensional parameters previously derived (Bull. Math. Biophysics,28, 355–362, 1966), the ventricular pressure expressed as a Fourier series, and several additional assumptions to derive expressions for the mechanical parameters of the ventricle: flow, muscle segment length, surface area, transmural force, wall tension and work. The wall of the ventricle is assumed to consist of three layers of muscle. Each of the mechanical parameters is expressed in terms of Fourier series.