• Title/Summary/Keyword: Ventricular pressure

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Conversion Arterial Switch Operation for Failed Sensing Procedure in TGA with VSD -One Case Report- (심방교체수술을 시행한 대혈관 전위증환자에서의 동맥전환술-1례 보고-)

  • 조유원;서동만
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.86-89
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    • 1996
  • This is a report of successful conversion arterial switch operation for failed Sunning procedure in transposition of the great arteries(TGA) with ventricular septal defect(VSD). A 15 month-male patient was admitted due to intractable congestive heart failure after Sunning operation was done at the age of 8 months. Angiography revealed marked dysfunction of the morphologic right ventricle with tricuspid regurgitation and residual VSD. The pulmonary ventricle 1 systemic ventricle pressure ratio' of 75/85 at catheter study enabled us to do the take down of denning repair, patch closure of VSD and arterial switch without pulmonary artery banding. After the operation, the baby showed good growth with normal ventricular function.

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Evaluations of vital signs and echocardiographic left ventricular function after the constant rate infusion of lidocaine and/or ketamine in Beagle dogs

  • Kim, Ye-Won;Choi, Miru;Kim, Tae-Jun;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.55 no.4
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    • pp.215-219
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    • 2015
  • Cardiopulmonary depression of long-term constant rate infusion (CRI) administration of multiple analgesic drugs is important, especially in critically ill dogs. Therefore, this study was conducted to evaluate the effects of lidocaine, ketamine or combined lidocaine-ketamine combination CRI treatment on vital signs and left ventricular (LV) function in healthy dogs. Six adult Beagle dogs were administered either ketamine (initial loading dose of 0.5 mg/kg followed by $10{\mu}g/kg/min$ CRI), lidocaine (initial loading dose of 2 mg/kg followed by 0.025 mg/kg/min CRI), or combined lidocaine-ketamine intravenously. Arterial blood pressure (BP), heart rate (HR), respiratory rate (RR), body temperature (BT) and echocardiographic LV dimensions were measured before administration of medications, immediately after administration of drugs, and then every 10 min for 2 h. There were no significant changes in HR, RR, BT and BP after the administration of either lidocaine CRI, ketamine CRI, or combined lidocaine and ketamine CRI. There were also no significant changes in LV dimensions and stroke volume. The results revealed that treatment with either lidocaine, ketamine or combined lidocaine-ketamine may not cause cardiopulmonary suppression in healthy dogs.

Method of Deciding Elastic Modulus of Left and Right Ventricle Reconstructed by Echocardiography Using Finite Element Method and Stress Analysis

  • Han, Geun-Jo;Kim, Sang-Hyun
    • Journal of Biomedical Engineering Research
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    • v.15 no.2
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    • pp.217-224
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    • 1994
  • In order to study the shape and dimensions of heart, a procedure to reconstruct a three dimensional left ventricular geometry from two dimensional echocardiographic images was studied including the coordinate transformation, curve fitting and interpolation utilizing three dimensional position registration arm. Nonlinear material property of the left ventricular myocardium was obtained by finite element method performed on the reconstructed geometry and by optimization techniques which compared the computer predicted 3D deformation with the experimentally determined deformation. Elastic modulus ranged from 3.5g/$cm^2$ at early diastole to l53g/$cm^2$ at around end diastole showing slightly nonlinear relationship between the modulus and the pressure. Afterwards using the obtained nonlinear material propertry the stress distribution related with oxyzen consumption rate was analyzed. The maximum and minimum of ${\sigma}_1$ (max. principal stress) occurred at nodes on the second level intersection points of x-axis with endocardium and with epicardium, respectively. And the tendency of the interventricular septum to be flattened was observed from the compressive ${\sigma}_1$ on the anterior, posterior nodes of left ventricle and from the most significant change of dimension in $D_{RL}$ (septal-lateral dimension of right ventricle).

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Numerical Study of Effect of counter-pulsation on Hemodynamic Response in the ECLS (체외생명구조장치에서 역박동 방법이 혈류역학 응답에 미치는 영향에 대한 수치적 연구)

  • Kim, In-Su;Lim, Ki-Moo;Choi, Seoung-Wook;Jun, Hyung-Min;Shim, Eun-Bo
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1660-1664
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    • 2008
  • Extra-corporeal Life Support System (ECLS) is the device used in emergency cases to substitute a extracorporeal circulation in open heart surgery, cardiac arrest or in acute cardiopulmonary failure. To obtain the effect of counter-pulsation on hemodynamic response in the ECLS quantitatively, we developed cardiovascular model which consists of 12 compartment model of heldt et al. and 3 compartment model of Schreiner et al. based on windkessel approximation. We compared coronary perfusion, arterial pulse pressure, cardiac output, and left ventricular pressure-volume diagram according to flow configuration such as counter-pulsation, copulsation, and continous flow. When counter-pulsation was applied, 5% higher coronary perfusion, 26% lower pulse pressure, and 2% higher cardiac output than copulsation condition were calculated. We conclude that counter-pulsation configuration in the ECLS is hemodynamically more stable than copulsation and influences the positive effect to recover ventricles.

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Energetics of the Heart Model with the Ventricu1ar Assist Device

  • Chung, Chanil-Chung;Lee, Sang-Woo;Han, Dong-Chul;Min, Byoung-Goo
    • Journal of Biomedical Engineering Research
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    • v.17 no.1
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    • pp.43-48
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    • 1996
  • We investigated the energistics of the physiological heart model by comparing predictive indexes of the myocardial oxygen consumption (MOC), such as tension-time index (R), tension-time or force-time inteual (FTI), rate-pressure product (RPP), pressure-work index, and systolic pressure-volume area (PVA) when using the electro-hydraulic left ventricular device (LVAD). We developed the model of LVAD incorporated the closed-loop cardiovascular system with a baroreceptor which can control heart rate and time-varying elastance of left and right ventricles. On considering the benefit of the LVAD, the effects of various operation modes, especially timing of assistance, were evaluated using this coupled computer model. Overall results of the computer simulation shows that our LVAD can unload the ischemic (less contractile) heart by decreasing the MU and increasing coronary flow. Because the pump ejection at the end diastolic phase of the natural heart may increase the afterload of the left ventricle, the control scheme of our LVAD must prohibit ejecting at this time. Since the increment of coronary flow is proportional to the peak aortic pressure after ventricle contraction, the LVAD must eject immediately following the closure of the aortic valve to increase oxygen availability.

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A Multi-scale Simulation Model of Circulation Combining Cardiovascular Hemodynamics with Cardiac Cell Mechanism (심근세포-심혈관계 혈류역학이 결합된 복합적 순환계 모델에 관한 연구)

  • Ko Hyung Jong;Leem Chae Hun;Shim Eun Bo
    • Journal of Institute of Control, Robotics and Systems
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    • v.10 no.12
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    • pp.1164-1171
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    • 2004
  • A new multi-scale simulation model is proposed to analyze heart mechanics. Electrophysiology of a cardiac cell is numerically approximated using the previous model of human ventricular myocyte. The ion transports across cell membrane initiated by action potential induce an excitation-contraction mechanism in the cell via cross bridge dynamics. Negroni and Lascano model (NL model) is employed to calculate the tension of cross bridge which is closely related to the ion dynamics in cytoplasm. To convert the tension on cell level into contraction force of cardiac muscle, we introduce a simple geometric model of ventricle with a thin-walled hemispheric shape. It is assumed that cardiac tissue is composed of a set of cardiac myocytes and its orientation on the hemispheric surface of ventricle remains constant everywhere in the domain. Application of Laplace law to the ventricle model enables us to determine the ventricular pressure that induces blood circulation in a body. A lumped parameter model with 7 compartments is utilized to describe the systemic circulation interacting with the cardiac cell mechanism via NL model and Laplace law. Numerical simulation shows that the ion transports in cell level eventually generate blood hemodynamics on system level via cross bridge dynamics and Laplace law. Computational results using the present multi-scale model are well compared with the existing ones. Especially it is shown that the typical characteristics of heart mechanics, such as pressure volume relation, stroke volume and ejection fraction, can be generated by the present multi-scale cardiovascular model, covering from cardiac cells to circulation system.

The Accuracy of Echocardiography and ECG in the Left Ventricular Hypertrophy (좌심실비대 진단에서 심장초음파와 심전도검사의 정확성)

  • Yang, SungHee;Lee, Jin-Soo;Kim, Changsoo
    • The Journal of the Korea Contents Association
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    • v.16 no.2
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    • pp.666-672
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    • 2016
  • We extracted 50 LVH patients out of 30'~80's who performing ECG and echocardiography examination. We used Devereux's theory to examinate LVH with echocardiography and used Sokolow-Lyon's theory to examinate LVH with ECG. We used regression and correlation analysis by SPSS, used ROC curve analysis to decide predominance of two ways of .Age, BMI, SBP and DBP whice are the danger factors of LVH and standard value of LVH diagnosis examination seems correlated. Out of 50 LVH patients, 50 patients were diagnosed LVH by echcardiography examination and only 21 patients were diagnosed LVH by ECG examination. Also echocardiography was AUC 99%, sensitivity 96%, singularity 95%, accuracy 95.5%. And ECG was AUC 76%, sensitivity 62%, singularity 76%, accuracy 68%.By comparing accuracy between echocardiography and ECG in diagnosing LVH, we could tell echocardiography was examination with higher accuracy. Therefore, if one was diagnosed with summit on 1st examination with ECG, considering age, body mass index, systolic blood pressure and dilator blood pressure, should offer echocardiography examination.

The Effects of Gamigunshimtang on the Ischemic Heart Disease & Heart cell in Rats (허혈성심장(虛血性心臟) 및 심장세포(心臟細胞)에 대(對)한 가미건심탕(加味健心湯)의 실험적(實驗的) 연구(硏究))

  • Park, Jung-Mi;Moon, Sang-Kwan;Go, Chang-Nam;Cho, Gi-Ho;Kim, Kyung-Suk;Bae, Hyung-Sup;Lee, Kyung-Sup
    • The Journal of Korean Medicine
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    • v.19 no.1
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    • pp.251-270
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    • 1998
  • The effects of Gamigunshimtang on the isolated perfused ischemic heart in rats, heart rates, left ventricular pressure, cardiac blood flow and cardiotoxicity were stu.died in H9C2 myoblast cell, myocardial slice culture The results were as follows: 1. The administration of Gamigunshimtang to the rat recovered effectively heart rate, left ventricular pressure and flow rate from the experimental ischemia in perfused rat heart. The release of lactic dehydrogenase after the ischemia also decreased compared to the control group. 2. The administration of Gamigunshimtang to H9C2 myoblast culture enhanced the cell proliferation and protected against doxorubicin and allylamine induced release of the lactic dehydrogenase into the culture medium. It also protected effectively against doxorubicin and allylamine induced decrease of Ca ATPase activity and the increase of NADPH-cytochrome C reductase activity in the microsome. 3. The administration of Gamigunshimtang to the rat myocardial slice culture protected effectively against doxorubicin and allylamine induced decreases of protein synthesis and ATP content, and increases of cvtosolic enzyme, creatin kinase into the medium and lipid peroxidation.

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Effect of Amrinone, a Selective Inhibitor of Phosphodiesterase III, on PMNs-induced Cardiac Dysfunction in Ischemia/reperfusion

  • Oh, Byung-Kwon;Kim, Hyoung-Ki;Choi, Soo-Ran;Song, Jin-Ho;Park, Eon-Sub;Choi, Byung-Sun;Park, Jung-Duck;Shin, Yong-Kyoo
    • The Korean Journal of Physiology and Pharmacology
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    • v.8 no.1
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    • pp.43-50
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    • 2004
  • Ischemia followed by reperfusion in the presence of polymorphonuclear leukocytes (PMNs) results in a marked cardiac contractile dysfunction. Amrinone, a specific inhibitor of phosphodiesterase 3, has an antioxidant activity against PMNs. Therefore, we hypothesized that amrinone could attenuate PMNs-Induced cardiac dysfunction by suppression of reactive oxygen species (ROS) produced fby PMNs. In the present study, we examined the effects of amrinone on isolated ischemic (20 min) and reperfused (45 min) rat hearts perfused with PMNs. Amrinone at $25\;{\mu}M$, given to hearts during the first 5 min of reperfusion, significantly improved coronary flow, left ventricular developed pressure (P<0.001), and the maximal rate of development of left ventricular developed pressure (P<0.001), compared with ischemic/reperfused hearts perfused with PMNs in the absence of amrinone. In addition, amrinone significantly reduced myeloperoxidase activity by 50.8%, indicating decreased PMNs infiltration (p< 0.001). Superoxide radical and hydrogen peroxide production were also significantly reduced in fMLP- and PMA-stimulated PMNs pretreated with amrinone. Hydroxyl radical was scavenged by amrinone. fMLP-induced elevation of $[Ca^{2+}]_i$ was also inhibited by amrinone. These results provide evidence that amrinone can significantly attenuate PMN-induced cardiac contractile dysfunction in the ischemic/reperfused rat heart via attenuation of PMNs infiltration into the myocardium and suppression of ROS release by PMNs.

The Protective Effect of Epigallocatechin-3 Gallate on Ischemia/Reperfusion Injury in Isolated Rat Hearts: An ex vivo Approach

  • Piao, Cheng Shi;Kim, Do-Sung;Ha, Ki-Chan;Kim, Hyung-Ryong;Chae, Han-Jung;Chae, Soo-Wan
    • The Korean Journal of Physiology and Pharmacology
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    • v.15 no.5
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    • pp.259-266
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    • 2011
  • The aim of this study was to evaluate the preventive role of epigallocatechin-3 gallate (EGCG, a derivative of green tea) in ischemia/reperfusion (I/R) injury of isolated rat hearts. It has been suggested that EGCG has beneficial health effects, including prevention of cancer and heart disease, and it is also a potent antioxidant. Rat hearts were subjected to 20 min of normoxia, 20 min of zero-flow ischemia and then 50 min of reperfusion. EGCG was perfused 10 min before ischemia and during the whole reperfusion period. EGCG significantly increased left ventricular developed pressure (LVDP) and increased maximum positive and negative dP/dt (+/-dP/dtmax). EGCG also significantly increased the coronary flow (CF) at baseline before ischemia and at the onset of the reperfusion period. Moreover, EGCG decreased left ventricular end diastolic pressure (LVEDP). This study showed that lipid peroxydation was inhibited and Mn-SOD and catalase expressions were increased in the presence of EGCG. In addition, EGCG increased levels of Bcl-2, Mn-superoxide dismutase (SOD), and catalase expression and decreased levels of Bax and increased the ratio of Bcl-2/Bax in isolated rat hearts. Cleaved caspase-3 was decreased after EGCG treatment. EGCG markedly decreased the infarct size while attenuating the increase in lactate dehydrogenase (LDH) levels in the effluent. In summary, we suggest that EGCG has a protective effect on I/R-associated hemodynamic alteration and injury by acting as an antioxidant and anti-apoptotic agent in one.