Ventricular dimensions measured noninvasively by echocardiography in the awake dog.

A surface echocardiographic technique was employed in 37 mongrel dogs for measurement of left ventricular dimensions. Intracardiac bolus injections of dextran were used as an echo contrast material to visualize cardiac chambers, and the identification of intracardiac structures was further confirmed by postmortem examination. The left ventricle could be satisfactorily visualized from both the right and left chest, providing two transverse left ventricular diameters nearly perpendicular to each other. End-diastolic and end-systolic diameter measurements in the two separate transverse planes differed by an average of only 0.07 and 0.1 cm, respectively, and dimensional measurements were reproducible from day to day. Diastolic diameter ranged from 3.0 to 4.7 cm (mean 3.7 cm) and systolic diameter 1.9 to 3.3 cm (mean 2.6 cm). Diameter was directly related to animal weight. Stroke volume calculated from the dimension measurements correlated with stroke volume calculated from indicator-dilution curves in 16 dogs. Ejection fraction averaged 0.67 and 0.54, depending on the formula used to calculate volumes. These results indicate that surface echocardiography can be employed to evaluate left ventricular dimensions in the awake dog.     

Uptake and metabolism of catecholamines in the awake dog

The contributions of uptake, metabolism and excretion to the removal of circulating dopamine (D) have been studied in comparison to those of adrenaline (A) and noradrenaline (NA). In two experiments radioactive catecholamines were infused during 80 min in an awake dog. In the first experiment [14C]D and D, L-[3H]A was used and in the second experiment these catecholamines were infused together with D, L-[14C]NA. Renal excretion of 14C-radioactivity was almost equal in both experiments, as was the case with the accumulation of 14C-components in plasma, demonstrating that the uptake of D was comparable to that of NA. The removal of [14C]D, [14C]NA and [3H]A, by uptake was 50, 50 and 13.5% respectively after 1 h. The conversion by metabolism was 46, 46 and 81%. Renal excretion was 3.5, 2 and 0.5%. Thus only 0.5, 2 and 5% was left in the extracellular fluid (ECF). In a report on similar experiments in anaesthetized dogs much higher levels of unchanged NA in plasma were measured. Probably this is due to anaesthesia inhibiting uptake. In the pulmonary circulation 14C-radioactivity was extracted at a constant rate during infusion which can mainly be attributed to extraneuronal uptake of [14C]D and to neuronal uptake of [14C]NA. Besides extraneuronal uptake of [3H]A in the lung expiration of [3H]water may contribute to the pulmonary extraction.     

Diaphragm length adjustments with body position changes in the awake dog

Sonomicrometry was used to measure end-expiratory length and tidal shortening of the costal and crural diaphragm in awake chronically instrumented dogs in the right lateral decubitus, standing, and sitting postures. End-expiratory length did not change significantly in standing but fell by 11.5% for the costal and by 14.4% for the crural segment in sitting, when compared with decubitus position. Tidal shortening of both segments did not change significantly in the three postures. From decubitus to sitting, diaphragmatic electromyogram (EMG) activity increased only in some dogs, not significantly for the group. The inspiratory swing of abdominal pressure was always positive in decubitus and negative in standing and sitting. In the latter two postures, abdominal pressure increased gradually during expiration and fell in inspiration, suggesting a phasic expiratory contraction of abdominal muscles. We conclude that diaphragmatic tidal shortening is maintained in the different postures assumed by the awake dog during resting breathing. It seems that the main compensatory mechanism for changes in diaphragmatic operational length is a phasic expiratory contraction of the abdominal muscles rather than an increase in diaphragmatic EMG activity.     

Interstitial fluid pressure gradient measured by micropuncture in excised dog lung

We have directly measured lung interstitial fluid pressure at sites of fluid filtration by micropuncturing excised left lower lobes of dog lung. We blood-perfused each lobe after cannulating its artery, vein, and bronchus to produce a desired amount of edema. Then, to stop further edema, we air-embolized the lobe. Holding the lobe at a constant airway pressure of 5 cmH2O, we measured interstitial fluid pressure using beveled glass micropipettes and the servo-null method. In 31 lobes, divided into 6 groups according to severity of edema, we micropunctured the subpleural interstitium in alveolar wall junctions, in adventitia around 50-micron venules, and in the hilum. In all groups an interstitial fluid pressure gradient existed from the junctions to the hilum. Junctional, adventitial, and hilar pressures, which were (relative to pleural pressure) 1.3 +/- 0.2, 0.3 +/- 0.5, and -1.8 +/- 0.2 cmH2O, respectively, in nonedematous lobes, rose with edema to plateau at 4.1 +/- 0.4, 2.0 +/- 0.2, and 0.4 +/- 0.3 cmH2O, respectively. We also measured junctional and adventitial pressures near the base and apex in each of 10 lobes. The pressures were identical, indicating no vertical interstitial fluid pressure gradient in uniformly expanded nonedematous lobes which lack a vertical pleural pressure gradient. In edematous lobes basal pressure exceeded apical but the pressure difference was entirely attributable to greater basal edema. We conclude that the presence of an alveolohilar gradient of lung interstitial fluid pressure, without a base-apex gradient, represents the mechanism for driving fluid flow from alveoli toward the hilum.     

Age-related changes in the biomechanics of left ventricular twist measured by speckle tracking echocardiography

The increasing number and proportion of aged individuals in the population warrants knowledge of normal physiological changes of left ventricular (LV) biomechanics with advancing age. LV twist describes the instantaneous circumferential motion of the apex with respect to the base of the heart and has an important role in LV ejection and filling. This study sought to investigate the biomechanics behind age-related changes in LV twist by determining a broad spectrum of LV rotation parameters in different age groups, using speckle tracking echocardiography (STE). The final study population consisted of 61 healthy volunteers (16-35 yr, n=25; 36-55 yr, n=23; 56-75 yr, n=13; 31 men). LV peak systolic rotation during the isovolumic contraction phase (Rot(early)), LV peak systolic rotation during ejection (Rot(max)), instantaneous LV peak systolic twist (Twist(max)), the time to Rot(early), Rot(max), and Twist(max), and rotational deformation delay (defined as the difference of time to basal Rot(max) and apical Rot(max)) were determined by STE using QLAB Advanced Quantification Software (version 6.0; Philips, Best, The Netherlands). With increasing age, apical Rot(max) (P<0.05), time to apical Rot(max) (P<0.01), and Twist(max) (P<0.01) increased, whereas basal Rot(early) (P<0.001), time to basal Rot(early) (P<0.01), and rotational deformation delay (P<0.05) decreased. Rotational deformation delay was significantly correlated to Twist(max) (R(2)=0.20, P<0.05). In conclusion, Twist(max) increased with aging, resulting from both increased apical Rot(max) and decreased rotational deformation delay between the apex and the base of the LV. This may explain the preservation of LV ejection fraction in the elderly.     

Novel ways to noninvasively detect inflammation of the myocardium: contrast-enhanced MRI and myocardial contrast echocardiography

Both contrast-enhanced magnetic resonance imaging (CE-MRI) and myocardial contrast echocardiography (MCE) are promising tools to detect cardiac inflammation. CE-MRI can be used to characterise the location and extent of myocardial inflammation, since areas of abnormal signal enhancement associated with regional wall motion abnormalities reliably indicate areas of active myocarditis. In MCE, chemically composed microbubbles can be visualised by ultrasound and used to determine the status of the cardiac microvasculature. If there is any inflammation the microbubbles will be phagocytosed by neutrophils and monocytes, thus enabling the degree of inflammation to be assessed.These noninvasive techniques may allow early diagnosis and accurate evaluation of myocardial inflammation.