Stroke Volume and the Three Phase Cardiac Output Rate Relationship with Ventricular Pacing

Wessale, Jerry L.; Voelz, M.; Geddes, L. A.

doi:10.1111/j.1540-8159.1990.tb02085.x

Cited by 13 publications

(6 citation statements)

References 27 publications

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“…When LHHM is configured to simulate pacing without exercise, the model outputs show that the stroke volume reduces with an increasing heart rate ( Figure 4 ). This result is in agreement with in vivo measurements reported in the literature [ 22 ]. Left atrium pressure traces at the fifth cardiac cycle for paced hearts are plotted for heart rates (90, 120, 140 and 160 bpm) and shown in Figure 5 .…”

Section: Resultssupporting

confidence: 93%

“…AV delays in the range of 40 ms to 250 ms were simulated in the Living Heart Human Model. The results on stroke volume show a clear peak at 120 ms in the LHHM at 90 bpm ( Figure 7 ), which agrees with the values reported in the literature [ 22 ]. Systolic blood pressure also shows a clear peak at 120 ms AV delay [ 25 ] ( Figure 7 ), which agrees with the study conducted by Manisty.…”

Section: Resultssupporting

confidence: 91%

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A Computationally Efficient Approach to Simulate Heart Rate Effects Using a Whole Human Heart Model

2022

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Computational modeling of the whole human heart has become a valuable tool to evaluate medical devices such as leadless pacemakers, annuloplasty rings and left ventricular assist devices, since it is often difficult to replicate the complex dynamic interactions between the device and human heart in bench-top and animal tests. The Dassault Systèmes Living Heart Human Model (LHHM) is a finite-element model of whole-human-heart electromechanics that has input parameters that were previously calibrated to generate physiological responses in a healthy heart beating at 60 beat/min (resting state). This study demonstrates that, by adjusting only six physiologically meaningful parameters, the LHHM can be recalibrated to generate physiological responses in a healthy heart beating at heart rates ranging from 90–160 beat/min. These parameters are as follows: the sinoatrial node firing period decreases from 0.67 s at 90 bpm to 0.38 s at 160 bpm, atrioventricular delay decreases from 0.122 s at 90 bpm to 0.057 s at 160 bpm, preload increases 3-fold from 90 bpm to 160 bpm, body resistance at 160 bpm is 80% of that at 90 bpm, arterial stiffness at 160 bpm is 3.9 times that at 90 bpm, and a parameter relating myofiber twitch force duration and sarcomere length decreases from 238 ms/mm at 90 bpm to 175 ms/mm at 160 bpm. In addition, this study demonstrates the feasibility of using the LHHM to conduct clinical investigations in AV delay optimization and hemodynamic differences between pacing and exercise. AV delays in the ranges of 40 ms to 250 ms were simulated and stroke volume and systolic blood pressure showed clear peaks at 120 ms for 90 bpm. For a heart during exercise, the increase in cardiac output continues to 160 bpm. However, for a heart during pacing, those physiological parameter adjustments are removed that are related to changes in body oxygen requirements (preload, arterial stiffness and body resistance). Consequently, cardiac output increases initially with heart rate; as the heart rate goes up (>100 bpm), the increasing rate of cardiac output slows down and approaches a plateau.

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Section: Resultssupporting

confidence: 93%

Section: Resultssupporting

confidence: 91%

A Computationally Efficient Approach to Simulate Heart Rate Effects Using a Whole Human Heart Model

2022

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“…When the study cohort consisted of subjects with in situ cardiac pacemakers, subjects could be paced from the right atrium (atrial pacing, Ap) (2,19,25,77), right ventricle (ventricular pacing, Vp) (3,25,35,59), or both the right atrium and the right ventricle (sequential atrioventricular pacing, ApVp) (3,35,77). Although hemodynamic consequences of pacing from different chambers in the heart have been well investigated (15,17,70,76), whether or not these consequences affect the HR relationship with arterial stiffness, arterial waveform shape, or arterial wave reflections have not been studied in detail. Past studies have found temporal changes relating to HR, such as ejection duration (ED), had a stronger association with the resultant changes in PWV (54) and AIx (58) than HR itself.…”

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confidence: 99%

Effects of pacing modality on noninvasive assessment of heart rate dependency of indices of large artery function

Tan

Kiat

Barin

et al. 2016

Journal of Applied Physiology

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Studies investigating the relationship between heart rate (HR) and arterial stiffness or wave reflections have commonly induced HR changes through in situ cardiac pacing. Although pacing produces consistent HR changes, hemodynamics can be different with different pacing modalities. Whether the differences affect the HR relationship with arterial stiffness or wave reflections is unknown. In the present study, 48 subjects [mean age, 78 ± 10 (SD), 9 women] with in situ cardiac pacemakers were paced at 60, 70, 80, 90, and 100 beats per min under atrial, atrioventricular, or ventricular pacing. At each paced HR, brachial cuff-based pulse wave analysis was used to determine central hemodynamic parameters, including ejection duration (ED) and augmentation index (AIx). Wave separation analysis was used to determine wave reflection magnitude (RM) and reflection index (RI). Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). Pacing modality was found to have significant effects on the HR relationship with ED (P = 0.01), central aortic pulse pressure (P = 0.01), augmentation pressure (P < 0.0001), and magnitudes of both forward and reflected waves (P = 0.05 and P = 0.003, respectively), but not cfPWV (P = 0.57) or AIx (P = 0.38). However, at a fixed HR, significant differences in pulse pressure amplification (P < 0.001), AIx (P < 0.0001), RM (P = 0.03), and RI (P = 0.03) were observed with different pacing modalities. These results demonstrate that although the HR relationships with arterial stiffness and systolic loading as measured by cfPWV and AIx were unaffected by pacing modality, it should still be taken into account for studies in which mixed pacing modalities are present, in particular, for wave reflection studies.

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“…In our previous study, the median (range) of total plasma clearance was greater at 22.4 (14.2–31.2) mL/min/kg. Ultimately, the relationship between heart rate and cardiac output would be determined by the magnitude of the change in heart rate (Wessale et al ., ). In our previous study, we did not document PD measurements.…”

Section: Discussionmentioning

confidence: 97%

Pharmacokinetics and pharmacodynamics of glycopyrrolate following a continuous‐rate infusion in the horse

Rumpler

Kandala

Vickroy

et al. 2013

Vet Pharm & Therapeutics

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Glycopyrrolate (GLY) is an antimuscarinic agent that is used in humans and domestic animals primarily to reduce respiratory tract secretions during anesthesia and to reverse intra-operative bradycardia. Although GLY is used routinely in veterinary patients, there is limited information regarding its pharmacokinetic (PK) and pharmacodynamic (PD) properties in domestic animals, and an improved understanding of the plasma concentration-effect relationship in racehorses is warranted. To accomplish this, we characterize the pharmacokinetic-pharmacodynamic (PK-PD) actions of GLY during and after a 2-h constant-rate intravenous infusion (4 μg/kg/h) and evaluate potential PK-PD models for cardiac stimulation in adult horses. Measurements of plasma GLY concentrations, heart and respiration rates, and frequency of bowel movements were performed in six Thoroughbred horses. The time course for GLY disposition in plasma followed a tri-exponential equation characterized by rapid disappearance of GLY from blood followed by a prolonged terminal phase. Physiological monitoring revealed significant (P < 0.01) increases in heart (>70 bpm) and respiratory rates accompanied by a marked and sustained delay in the frequency of bowel movements (1.1 ± 0.2 h [saline group] vs. 6.0 ± 2.0 h [GLY group]). Two of six horses showed signs of colic during the 8-h observation period after the end of the GLY infusion, but were treated and recovered without further complications. The relationship between plasma GLY concentration and heart rate exhibited counterclockwise hysteresis that was adequately described using an effect compartment.

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Stroke Volume and the Three Phase Cardiac Output Rate Relationship with Ventricular Pacing

Cited by 13 publications

References 27 publications

A Computationally Efficient Approach to Simulate Heart Rate Effects Using a Whole Human Heart Model

A Computationally Efficient Approach to Simulate Heart Rate Effects Using a Whole Human Heart Model

Effects of pacing modality on noninvasive assessment of heart rate dependency of indices of large artery function

Pharmacokinetics and pharmacodynamics of glycopyrrolate following a continuous‐rate infusion in the horse

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