Reference : Alteration of Right Ventricular-Pulmonary Vascular Coupling in a Porcine Model of Progre...
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
http://hdl.handle.net/2268/80234
Alteration of Right Ventricular-Pulmonary Vascular Coupling in a Porcine Model of Progressive Pressure Overloading
English
Ghuysen, Alexandre mailto [Université de Liège - ULg > Département des sciences de la santé publique > Réanimation - Urgence extrahospitalière]
Lambermont, Bernard mailto [Centre Hospitalier Universitaire de Liège - CHU > > Frais communs médecine >]
Kolh, Philippe mailto [Université de Liège - ULg > Département des Sciences biomédicales et précliniques > Service de biochimie et de physiologie générales, humaines, normales et pathologiques > >]
Tchana-Sato, Vincent [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire >]
Magis, David mailto [Université de Liège - ULg > Département de mathématique > Département de mathématique >]
Gérard, Paul mailto [Université de Liège - ULg > Département de mathématique > Statistique (aspects expérimentaux) >]
Mommens, V. [> > > >]
Janssen, Nathalie mailto [Centre Hospitalier Universitaire de Liège - CHU > > Urgences >]
Desaive, Thomas mailto [Université de Liège - ULg > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles >]
D'Orio, Vincenzo mailto [Université de Liège - ULg > Département des sciences cliniques > Médecine d'urgence - bioch. et phys. hum. normales et path.]
2008
Shock (Augusta, Ga.)
29
2
197-204
Yes (verified by ORBi)
International
1073-2322
[en] In acute pulmonary embolism, right ventricular (RV) failure may result from exceeding myocardial contractile resources with respect to the state of vascular afterload. We investigated the adaptation of RV performance in a porcine model of progressive pulmonary embolism. Twelve anesthetized pigs were randomly divided into two groups: gradual pulmonary arterial pressure increases by three injections of autologous blood clot (n = 6) or sham-operated controls (n = 6). Right ventricular pressure-volume (PV) loops were recorded using a conductance catheter. Right ventricular contractility was estimated by the slope of the end-systolic PV relationship (Ees). Afterload was referred to as pulmonary arterial elastance (Ea) and assessed using a four-element Windkessel model. Right ventricular-arterial coupling (Ees/Ea) and efficiency of energy transfer (from PV area to external mechanical work [stroke work]) were assessed at baseline and every 30 min for 4 h. Eaincreased progressively after embolization, from 0.26 +/- 0.04 to 2.2 +/- 0.7 mmHg mL (P < 0.05). Ees increased from 1.01 +/-0.07 to 2.35 +/- 0.27 mmHg mL (P < 0.05) after the first two injections but failed to increase any further. As a result, Ees/Ea initially decreased to values associated with optimal SW, but the last injection was responsible for Ees/Ea values less than 1, decreased stroke volume, and RV dilation. Stroke work/PV area consistently decreased with each injection from 79% +/- 3% to 39% +/- 11% (P < 0.05). In response to gradual increases in afterload, RV contractility reserve was recruited to a point of optimal coupling but submaximal efficiency. Further afterload increases led to RV-vascular uncoupling and failure.
Researchers ; Professionals
http://hdl.handle.net/2268/80234
10.1097/SHK.0b013e318070c790

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