Influence of the thyroid state on left ventricular tension-velocity relations in the intact, sedated dog

The mechanical properties of left ventricular contraction were described in terms of tension, velocity, length, and time in closed-chest, sedated normal, hypothyroid, and hyperthyroid dogs. Heart rate was controlled at 150 beats/min, and instantaneous contractile element velocity was calculated from left ventricular pressure and its first derivative during isovolumic left ventricular contractions, produced by sudden balloon occlusion of the ascending aorta during diastole. Wall tension was derived from ventricular pressure and volume, the latter being obtained from the pressure-volume relation of the arrested ventricle, and tension-velocity relations were analyzed over a range of ventricular endiastolic volumes. At any level of ventricular volume, the hypothyroid state was associated with a displacement of the tension-velocity relation of the left ventricle downwards and to the left, and the time to peak tension was prolonged (154 msec, normal 139 msec). In the hyperthyroid state, the tension-velocity relation of the left ventricle was displaced upwards and to the right, and the time to peak tension was reduced (80 msec). The changes in the tension-velocity relations indicate that the inotropic state of the left ventricle in the intact dog varies directly with the animal's thyroid state. This influence on myocardial contractility necessarily constitutes an important and integral part of the response of the intact circulation to altered thyroid state.

Left ventricular function in experimental aorto-caval fistula with circulatory congestion and fluid retention

The mechanical properties of left ventricular contraction were described in terms of tension, velocity, length, and time in closed-chest, sedated dogs in which a large aorto-caval fistula had resulted in circulatory congestion, and the results were compared with those in normal dogs. Instantaneous contractile element velocity was calculated from left ventricular pressure and its first derivative during isovolumic left ventricular contractions produced by sudden balloon occlusion of the ascending aorta during diastole. A range of ventricular end-diastolic volumes was induced and heart rate was controlled at 150 beats/min. Wall tension (stress) was derived from ventricular pressure and volume, the latter being obtained from the pressure-volume relation of the passive ventricle. Extrapolated velocity at zero tension, V(max), averaged 3.0 circ/sec in the normal dogs and 2.9 circ/sec in the seven dogs with an aorto-caval fistula and fluid retention; in only one of these seven animals was V(max) below the lower limit of normal of 2.7 circ/sec. Isovolumic tension (P(o)) in dogs with aorto-caval fistulas tended to be slightly greater than normal at low ventricular filling pressures, and there was no difference in P(o) between the two groups of animals at high ventricular filling pressures. Time to peak pressure averaged 151 +/- 6 (SE) msec (normal 139 +/- 3). Left ventricular weight averaged 6.32 +/- 0.23 g/kg of initial body weight (normal 5.25 +/- 0.56 g/kg) (P < 0.001), which reflected moderate ventricular hypertrophy, and ventricular internal volume at a given filling pressure was increased proportionally. Therefore, the ventricular contractile state usually was normal in the dog with a large aorto-caval fistula, and it is proposed that mechanisms for fluid retention that results in circulatory congestion were activated because of the large hemodynamic burden despite normal myocardial contractile properties.

A quantitative analysis of left ventricular myocardial function in the intact, sedated dog

Instantaneous contractile element velocity was calculated from left ventricular pressure and its first derivative during isovolumic left ventricular contractions produced by sudden balloon occlusion of the ascending aorta during diastole in closed-chest, sedated dogs. Wall tension was derived from ventricular pressure and volume, the latter being obtained from the pressure-volume relation of the arrested ventricle. During isovolumic contractions, there was an inverse curvilinear relation between tension and velocity, except at the onset of contraction and near peak tension. Increasing diastolic ventricular volume shifted the tension-velocity relations to the right, with increase in mean total isovolumic tension from 188 to 471 g/cm 2 , but without an obvious change in extrapolation to maximum velocity, which averaged 3.0 circumferences/sec. End-diastolic pressure-tension and circumference-tension relations indicated that active tension development continued to increase up to the maximum measured enddiastolic pressures of approximately 20 mm Hg. The normalized data, pooled from 15 animals, showed little scatter in the data for tension and velocity. It is concluded that the contractile properties of left ventricular muscle in the intact, sedated dog may be meaningfully described by tension-velocity relations obtained from single isovolumic contractions. The responses of the intact ventricle to increased diastolic volume and digitalis glycosides are analogous to those of isolated cardiac muscle. The small variability in the normalized tension-velocity relations in the normal dog suggests that it will also be possible to characterize abnormal left ventricular function with this approach.

Beta-adrenergic blockade in the treatment of exercise-induced paroxysmal ventricular tachycardia

The β-adrenergic blocking drug pronethalol was effective in the treatment of a patient with exercise-induced paroxysmal ventricular tachycardia. Adrenergic stimuli are considered important in initiating this arrhythmia. The mode of action of pronethalol is briefly discussed in relation to other antiarrhythmic agents.