Immediate effect of expiratory loading on left ventricular stroke volume.

Abstract:

:While the steady-state effects of positive pleural pressure on the circulation have been extensively studied, less is known about the immediate effects of positive intrathoracic pressure on cardiac dynamics. Therefore, we performed electrocardiographically gated radionuclide ventriculography with a respiratory gating technique in nine healthy subjects during quiet breathing and during expiration against a 24 cm H2O expiratory threshold load. During expiration, respiratory loading caused an increase in stroke counts by 29.4% (p less than .001) due to an increase in end-diastolic counts of 26.1% (p less than .001). End-systolic counts also rose 18.8% (p less than .05). The ejection fraction did not change significantly. These findings indicate that the increase in left ventricular stroke volume that occurs during the first 1 or 2 beats of a loaded expiration is due to an increase in left ventricular filling and not to augmentation of left ventricular ejection. This immediate increase in pulmonary venous return may reflect increased distensibility of the left ventricle due to decreased filling of the right ventricle.

journal_name

Circulation

journal_title

Circulation

authors

Natarajan TK,Wise RA,Karam M,Permutt S,Wagner HN Jr

doi

10.1161/01.cir.75.1.139

subject

Has Abstract

pub_date

1987-01-01 00:00:00

pages

139-45

issue

1

eissn

0009-7322

issn

1524-4539

journal_volume

75

pub_type

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