Evaluation of left ventricular residual function using postextrasystolic potentiation. Relation between systolic time intervals and angiographic study.

Yamazoe, Masaru; Hoshino, Yumiko; Tomonaga, Tetsuro; Oda, Hirotaka; Izumi, Tohru; Arai, Yutaka; Shibata, Akira; Makino, Hideo; Saitoh, Yoshiaki

doi:10.1536/ihj.27.797

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Garrard's equation was used for calculating ejection fraction from STI (6,11). The basis of using PEP/VET ratio to derive EF has been validated before (6,12). End diastolic volume (EDV) was calculated by dividing SV by EF.…”

Section: Methodsmentioning

confidence: 99%

The maternal hemodynamic effects of bupivacaine‐epinephrine mixture used for obstetrical anesthesia

Grant¹,

Ramanathan²,

Turndorf³

1990

Acta Anaesthesiol Scand

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The maternal hemodynamic effects of bupivacaine (0.5%)-epinephrine (5 micrograms/ml) mixture used for lumbar epidural anesthesia were studied with an impedance cardiograph and an automated blood pressure device in term gravidas undergoing elective cesarean section. Following i.v. hydration with 2000 ml Ringer's lactate solution, 16 patients received bupivacaine-epinephrine mixture and 16 patients plain bupivacaine in 5-ml increments to a T4 level. Measurements were made before anesthesia, at T10 and at T4 sensory levels. Results were analyzed using analysis of variance (ANOVA) and the least significant difference method at P less than 0.05. In the epinephrine group, at T10 level, the diastolic (D) and mean (M) pressures decreased significantly 11 +/- 3, and 10 +/- 1% (mean +/- s.e. mean) respectively with no significant change in the S pressure. No significant changes were seen in the plain group. At T4, the S, D and M pressures decreased significantly 8 +/- 2, 18 +/- 4 and 16 +/- 2% in the epinephrine group. In the plain group the decrease in each one of these pressures was less than 5% and was not significant. In the epinephrine group, S, D and M pressures decreased significantly more than they did in the plain group at T10 and T4. Systemic vascular resistance decreased significantly from control values by 19 +/- 6% at T4 in the epinephrine group with no significant changes in the plain group.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Methodsmentioning

confidence: 99%

The maternal hemodynamic effects of bupivacaine‐epinephrine mixture used for obstetrical anesthesia

Grant¹,

Ramanathan²,

Turndorf³

1990

Acta Anaesthesiol Scand

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“…Dieser Effekt konnte insbesondere auch bei düatativer Kardiomyopathie nachgewiesen werden [7,8]. Ähnliche Ergebnisse fanden sich bei Variationen der Zyklusintervalle bei Vorhofnimmern (9).…”

Section: Diskussionunclassified

Nachlast und Blutdruckamplitude bei dilatativer Kardiomyopathie. Afterload and Blood Pressure Amplitude in Dilated Cardiomyopathy

Leder¹,

Baumert²,

Baier³

et al. 2002

Biomedizinische Technik/Biomedical Engineering

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The beat-to-beat variability of the diastolic blood pressure induces small variations in the afterload of the left ventricle. These variations influence myocardial contractility, and thus blood pressure amplitude. We assessed the interdependence of blood pressure and changes in the afterload. We continuously recorded blood pressure (duration 200 s, at rest) in 20 patients with dilated cardiomyopathy (ejection fraction 32 +/- 13%, left ventricular diameter 67 +/- 8 mm) and in 20 healthy volunteers. Interbeat intervals, diastolic pressures, systolic pressure amplitudes and mean slopes of systolic pressure amplitudes were measured. Correlation coefficients (r) were calculated to assess the interdependence of blood pressure amplitudes/mean systolic slopes and the preceding diastolic pressures/interbeat intervals, respectively. In healthy volunteers we found a strong interdependence between blood pressure amplitude and the preceding diastolic pressures (r = 0.62 +/- 0.21 and 0.47 +/- 0.22). Higher diastolic pressures were followed by higher blood pressure amplitudes, and by steeper slopes of the systolic peaks. In patients with dilated cardiomyopathy, such interdependence was significantly lower (r = 0.33 +/- 22 and r = 0.28 +/- 0.35), and in patients with severely reduced left ventricular function (ejection fraction < 32%) was only marginal (r = 0.23 +/- 0.27 and 0.21 +/- 0.44, respectively). The forces of the isovolumetric contraction necessary to initiate the ejection phase of the left ventricle depend on the afterload, i.e. on the diastolic pressure. The responses of amplitude and slope of the systolic blood pressure to small changes in the afterload make it possible to assess left ventricular contractility. The latter is impaired in dilated cardiomyopathy.

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“…Similarly, systolic time intervals measured by the impedance technique show a good correlation with those obtained by other invasive and non-invasive techniques (5,6,9,13,14). Many authors have found a good correlation between the PEP/LVET ratio and EF (7,(15)(16)(17)(26)(27)(28)(29). Once stroke volume and EF are known, it is a simple matter to calculate EDV (cardiac preload).…”

Section: Bementioning

confidence: 99%

Vasopressor therapy for hypotension due to epidural anesthesia for cesarean section

Ramanathan

Grant

1988

Acta Anaesthesiol Scand

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Maternal hemodynamic changes and neonatal acid-base status were assessed in 127 healthy patients undergoing elective cesarean section under epidural anesthesia. An impedance cardiograph was used to measure stroke volume (SV), ejection fraction (EF) and end-diastolic volume (EDV). In addition, neonatal umbilical venous and arterial PO2, PCO2, pH, base excess, lactate, pyruvate, excess lactate, and L/P ratio were measured at birth. Patients were divided into three groups. Group 1 (n = 53) required no vasopressor (normotensive controls). In Group 2 (n = 37), mean blood pressure (BP) decreased from 90 mmHg (13.3 kPa). In Group 3 (n = 37), BP decreased from 83 mmHg to 62 mmHg (11.1 to 8.2 kPa), and phenylephrine was administered in 100 micrograms increments to maintain systolic BP greater than 100 mmHg (13.3 kPa). In Groups 2 and 3 the SV and EDV decreased 43% and 33% respectively when hypotension developed. Both vasopressors restored BP, SV and EDV to near baseline values. Neonatal Apgar scores and acid-base profiles were not significantly different among the three groups of neonates, nor were they different between the two hypotensive groups. It is concluded that: 1) transient maternal hypotension does not affect neonatal acid-base status; 2) both ephedrine and phenylephrine increase cardiac preload; and 3) an alpha agent like phenylephrine does not cause fetal acidosis when used for treating maternal hypotension.

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Evaluation of left ventricular residual function using postextrasystolic potentiation. Relation between systolic time intervals and angiographic study.

Cited by 3 publications

References 30 publications

The maternal hemodynamic effects of bupivacaine‐epinephrine mixture used for obstetrical anesthesia

The maternal hemodynamic effects of bupivacaine‐epinephrine mixture used for obstetrical anesthesia

Nachlast und Blutdruckamplitude bei dilatativer Kardiomyopathie. Afterload and Blood Pressure Amplitude in Dilated Cardiomyopathy

Vasopressor therapy for hypotension due to epidural anesthesia for cesarean section

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