Reference : Effects of endotoxic shock on right ventricular systolic function and mechanical efficie...
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
http://hdl.handle.net/2268/41226
Effects of endotoxic shock on right ventricular systolic function and mechanical efficiency
English
Lambermont, Bernard mailto [Centre Hospitalier Universitaire de Liège - CHU > > Frais communs médecine >]
Ghuysen, Alexandre mailto [Université de Liège - ULg > Département des sciences de la santé publique > Réanimation - Urgence extrahospitalière]
Kolh, Philippe mailto [Université de Liège - ULg > Département des sciences biomédicales et précliniques > Service de Biochimie et de Physiologie humaines, normale et pathologique > > >]
Tchana-Sato, Vincent [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire >]
Segers, P. [Universiteit Gent - Ugent > > > > > >]
Gérard, Paul mailto [Université de Liège - ULg > Département de mathématique > Statistique (aspects expérimentaux) >]
Morimont, Philippe mailto [Centre Hospitalier Universitaire de Liège - CHU > > Frais communs médecine >]
Magis, David mailto [Université de Liège - ULg > Département de mathématique > Département de mathématique >]
Dogné, Jean-Michel [Université de Liège - ULg > Département de pharmacie > Département de pharmacie >]
Masereel, B. [Facultés Universitaires Notre-Dame de la Paix - Namur - FUNDP > > > >]
D'Orio, Vincenzo mailto [Université de Liège - ULg > Département des sciences cliniques > Médecine d'urgence - bioch. et phys. hum. normales et path.]
1-Aug-2003
Cardiovascular Research
Elsevier Science Bv
59
2
412-418
Yes (verified by ORBi)
International
0008-6363
Amsterdam
[en] contractile function ; endotoxins ; hemodynamics ; pulmonary circulation ; septic shock
[en] Objective: To investigate the effects of endotoxin infusion on right ventricular (RV) systolic function and mechanical efficiency. Methods: Six anesthetized pigs (Endo group) received a 0.5 mg/kg endotoxin infusion over 30 min and were compared with six other anesthetized pigs (Control group) receiving placebo for 5 h. RV pressure-volume (PV) loops were obtained by the conductance catheter technique and pulmonary artery flow and pressure were measured with high-fidelity transducers. Results: RV adaptation to increased afterload during the early phase of endotoxin-induced pulmonary hypertension (T30) was obtained by both homeometric and hetereometric regulations: the slope of the end-systolic PV relationship of the right ventricle increased from 1.4+/-0.2 mmHg/ml to 2.9+/-0.4 mmHg/ml (P<0.05) and RV end-diastolic volume increased from 56+/-6 ml to 64+/-11 ml (P<0.05). Consequently, right ventricular-vascular coupling was maintained at a maximum efficiency. Ninety minutes later (T120), facing the same increased afterload, the right ventricle failed to maintain its contractility to such an elevated level and, as a consequence, right ventricular-vascular uncoupling occurred. PV loop area, which is known to be highly correlated with oxygen myocardial consumption, increased from 1154+/-127 mmHg/ml (T0) to 1798+/-122 mmHg/ml (T180) (P<0.05) while RV mechanical efficiency decreased from 63+/-2% (T0) to 45+/-5% (T270) (P<0.05). Conclusions: In the very early phase of endotoxinic shock, right ventricular-vascular coupling is preserved by an increase in RV contractility. Later, myocardial oxygen consumption and energetic cost of RV contractility are increased, as evidenced by the decrease in RV efficiency, and right ventricular-vascular uncoupling occurs. Therefore, therapies aiming at restoring right ventricular-vascular coupling in endotoxic shock should attempt to increase RV contractility and to decrease RV afterload but also to preserve RV mechanical efficiency. (C) 2003 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
Researchers
http://hdl.handle.net/2268/41226
http://www.elsevier.com/wps/find/journaldescription.cws_home/525398/description#description

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