Isoproterenol-induced hypertrophy may result in distinct left ventricular changes

1. the aim of the present study was to analyse the possible lack of uniformity in isoproterenol (ISO)-induced myocardial hypertrophy.2. Data obtained for isovolumic hearts isolated from 20 rats treated with ISO (0.3 mg/kg over 8 days) were divided into two groups (H-1, n=10; H-2, n = 10) according to the volume (mean +/- SD) needed to change left ventricle diastolic pressure front 0 to 40 mmHg (H-1, 181 +/- 30 mu L; H-2, 108 +/- 14 mu L). Eight control rats (C; 165 +/- 37 mu L) were used for comparison.3. in addition to ventricular distensibility differences, the groups differed in terms of myocardial mass (mean +/- SEM: HI, 181 +/- 3 mg > H-2, 166 +/- 3 mg > C, 136 +/- 3 mg; P H-1, 28 +/- 2 msec; P = 0.0012) and of maximum developed circumferential stress (C, 145 +/- 9 kdyn/cm(2) = H-1, 137 +/- 6 kdynlcm' > H-2, 110 +/- 4 kdyn/cm(2); P = 0.002).4. Our results show that ISO-induced myocardial hypertrophy is not homogeneous. Data obtained for H-2, taken as a whole and compared with H-1 (smaller myocardial mass and impairment of relaxation, elastic stiffness and force generation), suggest that, in some animals, myocardial necrosis and reparative fibrosis may prevail over the stimulus for myocyte growth. the lack of uniformity of ISO-induced myocardial hypertrophy has not been previously reported and may have contributed to the divergence observed in the literature regarding the functional characteristics of the present model.Universidade Federal de São Paulo, Dept Physiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Physiol, São Paulo, BrazilWeb of Scienc

THE ABSENCE OF THE DESCENDING-LIMB OF THE FRANK-STARLING CURVE OF THE DEPRESSED GUINEA-PIG WHOLE VENTRICLE

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LEFT-VENTRICULAR MASS ESTIMATED BY M-MODE ECHOCARDIOGRAM IS NOT ALTERED BY CHANGES IN CARDIAC SHAPE AND DIMENSIONS DUE TO ACUTE ARTERIAL-HYPERTENSION

The effect of changes in left ventricular (LV) shape and dimensions due to acute arterial hypertension induced by mechanical obstruction of the aorta for 10 min on LV mass values estimated by M-mode echocardiogram was studied in 14 anesthetized dogs. Although the systolic pressure increased from 117.5 +/- 19.9 to 175.4 +/- 22.9 mmHg altered ventricular diameter from 2.77 +/- 0.49 cm to 3.17 +/- 0.67 cm (P<0.05) and wall thickness from 0.83 +/- 0.09 to 0.75 +/- 0.09 cm (P<0.05), LV mass estimated before (73.5 +/- 19.1 g) and after (78.3 +/- 26.4 g) hypertension was not significantly different. We demonstrate here for the first time that changes in LV dimensions induced by acute arterial hypertension do not modify LV mass values estimated by the M-mode electrocardiogram method

LEFT-VENTRICULAR MAXIMAL SYSTOLIC ELASTANCE CALCULATED BY A COMBINATION OF M-MODE ECHOCARDIOGRAPHY AND STANDARD MANOMETRY

1. A method for obtaining the end-systolic left ventricular (LV) pressure-diameter and stress-diameter relationships in man was critically analyzed.2. Pressure-diameter and stress-diameter relationships were determined throughout the cardiac cycle by combining standard LV manometry with M-mode echocardiography. Nine adult patients with heart disease and without heart failure were studied during intracardiac catheterization under three different conditions of arterial pressure, i.e., basal (B) condition (mean +/- SD systolic pressure, 102 +/- 10 mmHg) and two stable states of arterial hypertension (H(I), 121 +/- 12 mmHg; H(II), 147 +/- 17 mmHg) induced by venous infusion of phenylephrine after parasympathetic autonomic blockade with 0.04 mg/kg atropine.3. Significant reflex heart rate variation with arterial hypertension was observed (B, 115 +/- 20 bpm; H(I), 103 +/- 14 bpm; H(II), 101 +/- 13 bpm) in spite of the parasympathetic blockade with atropine. The linear end-systolic pressure-diameter and stress-diameter relationships ranged from 53.0 to 160.0 mmHg/cm and from 97.0 to 195.0 g/cm3, respectively.4. The end-systolic LV pressure-diameter and stress-diameter relationship lines presented high and variable slopes. The slopes, which are indicators of myocardial contractility, are susceptible to modifications by small deviations in the measurement of the ventricular diameter or by delay in the pressure curve recording

CHARACTERISTICS OF ARTERIAL-HYPERTENSION IN RESPONSE TO BOLUS INJECTION OF PHENYLEPHRINE IN ATROPINIZED PATIENTS

The changes of arterial pressure promoted by bolus injection of 50 mg phenylephrine (PHE) were studied in 20 atropinized patients (5 normal subjects, 13 patients with mitral valve disease, 1 patient with essential arterial hypertension and 1 patient with hypertrophic cardiomyopathy) submitted to routine catheterism. Patients with aortic valve disease, left ventricular outflow tract obstruction and intracardiac shunt were excluded from the study. All patients were in sinus rhythm, without heart failure. Arterial pressure started to increase at 14.8 +/- 5.4 s (range, 5.6 to 27 s; mean +/- SD) after PHE. There was an increase of 37.8 +/- 16.7 mmHg (range, 12.5 to 70 mmHg) in systolic pressure and of 26.6 +/- 11.1 mmHg (range, 7.5 to 42.5 mmHg) in diastolic pressure. Peak hypertension was attained at 36.6 +/- 16.4 s (range, 10.8 to 64.9 s) and hypertension continued for 176 +/- 92 s (range, 11 to 365 s). Heart rate was 114 +/- 21 bpm before PHE and 111 +/- 21 bpm (P<0.05) after PHE. There were no adverse events associated with intravenous PHE injection in any patient, in accordance with the general view that bolus injection of PHE is a safe and practical maneuver to promote arterial hypertension

Arterial-hypertension in the elderly

The authors review the epidemiology, the etiological factors, the effect of the treatment in the evolution of the cardiovascular disease in arterial hypertension in elderly, and the use of angiotensin-converting-enzyme inhibitors such as a treatment option