The measurement of coronary blood flow, oxygen consumption, and efficiency of the left ventricle in man

Bing, Richard J.; Hammond, MC; Handelsman, Jacob C.; Powers, Samuel R.; Spencer, Frank C.; Eckenhoff, James E.; Goodale, Walter T.; Hafkenschiel, Joseph H.; Kety, Seymour S.

doi:10.1016/0002-8703(49)90788-7

Cited by 398 publications

(87 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…15, 16 Efficiency can be precisely quantified using invasive measurement of ventricular stroke work and myocardial oxygen consumption. 15 This concept has been used successfully to assess the effects of medical therapy on the heart. 16 To evaluate myocardial efficiency non-invasively, an index known as the "work metabolic index" is usually used.…”

Section: Arakawa K Et Almentioning

confidence: 99%

Abnormal Myocardial Energy-Production State in Mitochondrial Cardiomyopathy and Acute Response to L-Arginine Infusion - C-11 Acetate Kinetics Revealed by Positron Emission Tomography -

Arakawa

Kudo

Ikawa

et al. 2010

Circ J

View full text Add to dashboard Cite

Section: Arakawa K Et Almentioning

confidence: 99%

Abnormal Myocardial Energy-Production State in Mitochondrial Cardiomyopathy and Acute Response to L-Arginine Infusion - C-11 Acetate Kinetics Revealed by Positron Emission Tomography -

Arakawa

Kudo

Ikawa

et al. 2010

Circ J

View full text Add to dashboard Cite

“…9 Currently, little is known about its physiological importance and its effects on metabolism, function, and efficiency of the transplanted heart. Mechanical efficiency of the ventricle is defined as the fraction of total expended metabolic energy that is converted into external contractile work 10 and has been used successfully to describe beneficial therapeutic effects in patients with heart failure. [11][12][13] By taking into account the energy cost for a given level of cardiac output, efficiency may also be a very sensitive parameter to characterize performance of the transplanted heart.…”

mentioning

confidence: 99%

Myocardial Efficiency and Sympathetic Reinnervation After Orthotopic Heart Transplantation

et al. 2001

View full text Add to dashboard Cite

Background-The lack of cardiac catecholamine uptake and storage caused by sympathetic denervation may influence performance of the transplanted heart. Reinnervation, occurring late after transplantation, may partially resolve these effects. In this study, oxidative metabolism and its relation to cardiac work were compared in allografts and normal and failing hearts, and the effects of sympathetic reinnervation were evaluated. Methods and Results-Twenty-seven nonrejecting, symptom-free transplant recipients, 11 healthy control subjects, and 10 patients with severe dilated cardiomyopathy underwent PET with 11 C acetate for assessment of oxidative metabolism by the clearance constant k(mono) and radionuclide angiography or MRI for measurement of ventricular function, geometry, and work. Efficiency was estimated noninvasively by a work-metabolic index [WMIϭ(stroke volumeϫheart rateϫsystolic pressure)/k(mono)]. In 14 of 27 transplants, presence of regional reinnervation was identified with PET and the catecholamine analogue 11 C hydroxyephedrine (extent, 24Ϯ14% of left ventricle). The WMI was comparable in normal subjects and reinnervated and denervated transplants (6.2Ϯ2.3 versus 4.9Ϯ2.0 versus 4.9Ϯ1.2 ⅐ 10 6 mm Hg · mL; PϭNS) and significantly lower in cardiomyopathy patients (3.0Ϯ1.3 ⅐ 10 6 mm Hg ⅐ mL; PϽ0.001). For normal subjects and transplant recipients, the WMI was significantly correlated with afterload (peripheral vascular resistance; rϭϪ0.65, PϽ0.01), preload (end-diastolic volume; rϭ0.78, PϽ0.01), and stroke volume (rϭ0.81, PϽ0.01) but not with hydroxyephedrine retention (transplants only; rϭ0.09, PϭNS). Conclusions-After transplantation, cardiac efficiency is improved compared with failing hearts and comparable to normal hearts. Differences between denervated and reinnervated allografts were not surveyed. Additionally, the dependency on loading conditions and contractility was preserved, suggesting that normal regulatory interactions for efficiency are intact and that sympathetic tone does not play a role under resting conditions.

show abstract

“…normal heart shown in figure 7 was obtained from the simultaneous pressure and volume curves of figure 6. This interesting curve shows that early in systole, during the phase of isometric contraction, there is a rapid rise in intraventricular pressure without any change in volume.…”

mentioning

confidence: 99%

The George Fahr Lecture

1952

View full text Add to dashboard Cite

This is a general theoretic consideration of certain mechanical peculiarities of the human heart. It inc'udes a discussion of mechanical advantages of the average size and average pressures, the effects of various pressures and ventricular volumes on ventricular work and "load," mechanical advantages of the structural arrangement of muscular fibers and manner of contraction, as well as the time course of ventricular work and power produced during a cardiac cycle. The role of the trabeculae carneae and papillary muscles in the emptying of a normal sized ventricle is also discussed.A LTHOUGH some thought has been given to the peculiarities of the mechanical nature of the human heart as a pump, the importance of these functional peculiarities is usually disregarded by those who discuss the hemodynamics of the cardiovascular system. Because of these mechanical factors the normal heart tends to maintain the same "load" or may even reduce its "load" as systole progresses and the intraventricular pressure increases. On the other hand, the dilated diseased heart loses this advantage, the loss being especially significant in the presence of arterial hypertension. It is the purpose of this theoretic discussion to indicate some of these hemodynamic principles and to point out some of the differences that exist between the normal and the dilated heart. In this presentation the term "load" denotes the force that must be supported by the ventricles of the heart during the cardiac cycle. Although the left ventricle of the human heart is considered throughout this presentation, the same concepts may be applied to the right ventricle as well as to the hearts of all animals which are shaped similar to and contract like that of man.

show abstract

The measurement of coronary blood flow, oxygen consumption, and efficiency of the left ventricle in man

Cited by 398 publications

References 14 publications

Abnormal Myocardial Energy-Production State in Mitochondrial Cardiomyopathy and Acute Response to L-Arginine Infusion - C-11 Acetate Kinetics Revealed by Positron Emission Tomography -

Abnormal Myocardial Energy-Production State in Mitochondrial Cardiomyopathy and Acute Response to L-Arginine Infusion - C-11 Acetate Kinetics Revealed by Positron Emission Tomography -

Myocardial Efficiency and Sympathetic Reinnervation After Orthotopic Heart Transplantation

The George Fahr Lecture

Contact Info

Product

Resources

About