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Acute and chronic response of the right ventricle to surgically induced pressure and volume overload--an analysis of pressure-volume relations.
Interact Cardiovasc Thorac Surg. 2010 Apr; 10(4):519-25.IC

Abstract

We aimed to determine the response of the right ventricle (RV) to surgically induced pressure and volume overload in both acute and chronic settings. Four-month-old sheep were operated via left anterior thoracotomy. Pressure overload of the RV was established by banding of the pulmonary trunk. Volume overload was induced by the implantation of a transannular patch to the right ventricular outflow tract. Right ventricular function was obtained with conductance catheters before and after surgery as well as three months postoperatively. Acute pressure overload resulted in an increase of end-systolic volume (ESV) (P=0.002) and end-diastolic volume (EDV) (P=0.004), increments in contractile indexes [maximal slope of systolic pressure increment (dP/dt(max)), P=0.002; slope of end-systolic pressure volume relation (Ees), P=0.002; preload recruitable stroke work (PRSW), P=0.002] and an acceleration of early diastole [relaxation time (tau), P=0.012; maximal slope of diastolic pressure decrement (dP/dt(min)), P=0.002]. Acute volume overload revealed better contractility and more prominent increases in preload (ESV, EDV; both P=0.008). Three months postoperatively, pressure overloaded hearts demonstrated superior systolic (Ees, P=0.022; PRSW, P=0.013) and diastolic reserves (dP/dt(min), P=0.013; slope of end-diastolic pressure volume relation (Eed), P=0.005; P(20), P=0.003) than volume overloaded hearts. Acute pressure overload leads to enhanced contractility of the RV as a result of the Anrep effect and the Frank-Starling mechanism whereas volume overload institutes only the latter. The chronically pressure overloaded RV exposes more contractile and elastic reserves than the chronically volume overloaded RV under stress conditions.

Authors+Show Affiliations

Department of Cardiac Surgery, Medical Faculty, University of Rostock, Schillingallee 35, 18057 Rostock, Germany. can.yerebakan@med.uni-rostock.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20089680

Citation

Yerebakan, Can, et al. "Acute and Chronic Response of the Right Ventricle to Surgically Induced Pressure and Volume Overload--an Analysis of Pressure-volume Relations." Interactive Cardiovascular and Thoracic Surgery, vol. 10, no. 4, 2010, pp. 519-25.
Yerebakan C, Klopsch C, Niefeldt S, et al. Acute and chronic response of the right ventricle to surgically induced pressure and volume overload--an analysis of pressure-volume relations. Interact Cardiovasc Thorac Surg. 2010;10(4):519-25.
Yerebakan, C., Klopsch, C., Niefeldt, S., Zeisig, V., Vollmar, B., Liebold, A., Sandica, E., & Steinhoff, G. (2010). Acute and chronic response of the right ventricle to surgically induced pressure and volume overload--an analysis of pressure-volume relations. Interactive Cardiovascular and Thoracic Surgery, 10(4), 519-25. https://doi.org/10.1510/icvts.2009.221234
Yerebakan C, et al. Acute and Chronic Response of the Right Ventricle to Surgically Induced Pressure and Volume Overload--an Analysis of Pressure-volume Relations. Interact Cardiovasc Thorac Surg. 2010;10(4):519-25. PubMed PMID: 20089680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute and chronic response of the right ventricle to surgically induced pressure and volume overload--an analysis of pressure-volume relations. AU - Yerebakan,Can, AU - Klopsch,Christian, AU - Niefeldt,Sabine, AU - Zeisig,Vilia, AU - Vollmar,Brigitte, AU - Liebold,Andreas, AU - Sandica,Eugen, AU - Steinhoff,Gustav, Y1 - 2010/01/20/ PY - 2010/1/22/entrez PY - 2010/1/22/pubmed PY - 2010/6/11/medline SP - 519 EP - 25 JF - Interactive cardiovascular and thoracic surgery JO - Interact Cardiovasc Thorac Surg VL - 10 IS - 4 N2 - We aimed to determine the response of the right ventricle (RV) to surgically induced pressure and volume overload in both acute and chronic settings. Four-month-old sheep were operated via left anterior thoracotomy. Pressure overload of the RV was established by banding of the pulmonary trunk. Volume overload was induced by the implantation of a transannular patch to the right ventricular outflow tract. Right ventricular function was obtained with conductance catheters before and after surgery as well as three months postoperatively. Acute pressure overload resulted in an increase of end-systolic volume (ESV) (P=0.002) and end-diastolic volume (EDV) (P=0.004), increments in contractile indexes [maximal slope of systolic pressure increment (dP/dt(max)), P=0.002; slope of end-systolic pressure volume relation (Ees), P=0.002; preload recruitable stroke work (PRSW), P=0.002] and an acceleration of early diastole [relaxation time (tau), P=0.012; maximal slope of diastolic pressure decrement (dP/dt(min)), P=0.002]. Acute volume overload revealed better contractility and more prominent increases in preload (ESV, EDV; both P=0.008). Three months postoperatively, pressure overloaded hearts demonstrated superior systolic (Ees, P=0.022; PRSW, P=0.013) and diastolic reserves (dP/dt(min), P=0.013; slope of end-diastolic pressure volume relation (Eed), P=0.005; P(20), P=0.003) than volume overloaded hearts. Acute pressure overload leads to enhanced contractility of the RV as a result of the Anrep effect and the Frank-Starling mechanism whereas volume overload institutes only the latter. The chronically pressure overloaded RV exposes more contractile and elastic reserves than the chronically volume overloaded RV under stress conditions. SN - 1569-9285 UR - https://www.unboundmedicine.com/medline/citation/20089680/Acute_and_chronic_response_of_the_right_ventricle_to_surgically_induced_pressure_and_volume_overload__an_analysis_of_pressure_volume_relations_ L2 - https://academic.oup.com/icvts/article-lookup/doi/10.1510/icvts.2009.221234 DB - PRIME DP - Unbound Medicine ER -