当前位置： SCI文献检索 > JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA期刊下所有文献 > Influence of isoflurane on left atrial function in dogs with pacing-induced cardiomyopathy: evaluation with pressure-volume relationships.

Influence of isoflurane on left atrial function in dogs with pacing-induced cardiomyopathy: evaluation with pressure-volume relationships.

Abstract：

OBJECTIVE:The actions of volatile anesthetics on left ventricular (LV) function in normal and failing hearts have been previously evaluated, but the effects of these agents on left atrial (LA) function in the presence of LV dysfunction are unknown. The hypothesis was tested that isoflurane alters LA mechanics evaluated with pressure-volume relations. DESIGN:Prospective. SETTING:Laboratory. PARTICIPANTS:Barbiturate-anesthetized dogs (n = 8) were instrumented for measurement of aortic, LA, and LV pressures (micromanometers), and LA volume (epicardial orthogonal sonomicrometers) after 3 weeks of rapid ventricular pacing (220 beats/min). INTERVENTIONS:LA myocardial contractility (E(es)) was assessed with end-systolic pressure-volume relations. LA stroke work and reservoir function were assessed by A and V loop area, respectively, from the steady-state pressure-volume diagram. LA-LV coupling was determined by the ratio of E(es) to LV elastance (E(LV)). Dogs received 0.6, 0.9, and 1.2 minimum alveolar concentration isoflurane in a random manner, and LA function was determined after a 20-minute equilibration at each dose. MEASUREMENTS AND MAIN RESULTS:Isoflurane significantly (p < 0.05) decreased heart rate, mean arterial pressure, LV end-systolic pressure, and LV +dP/dt(max). Isoflurane produced dose-related reductions in E(es) and E(es)/E(LV). Declines in LA stroke work, emptying fraction, reservoir volume, V loop area, and the active LA contribution to LV filling also occurred. CONCLUSIONS:The results indicate that isoflurane depresses LA myocardial contractility, impairs LA-LV coupling, and reduces active LA contribution to LV filling in dogs with pacing-induced cardiomyopathy. The impact of isoflurane on LA function in the presence of LV dysfunction has profound effects on cardiac performance.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Kehl F,Ladisa JF Jr,Hettrick DA,Kersten JR,Warltier DC,Pagel PS

doi

10.1053/j.jvca.2003.09.006

keywords:

subject

Has Abstract

pub_date

2003-12-01 00:00:00

pages

709-14

issue

eissn

1053-0770

issn

1532-8422

pii

S1053077003002672

journal_volume

pub_type

杂志文章

在线工具

Influence of isoflurane on left atrial function in dogs with pacing-induced cardiomyopathy: evaluation with pressure-volume relationships.