THE RELATION BETWEEN CARDIAC SIZE AND CARDIAC OUTPUT PER MINUTE FOLLOWING THE ADMINISTRATION OF DIGITALIS IN NORMAL DOGS

Regional hemodynamic effects of a digitalis glycoside in the conscious dog with and without experimental heart failure

The effects of intravenous ouabain (G-strophanthin), 20 µg/kg, on the superior mesenteric, renal, and external iliac beds were studied over a 30-minute period in eight normal conscious dogs before, and in five of them after, cholinergic blockade and in six conscious dogs with heart failure produced by tricuspid avulsion and progressive pulmonary stenosis. Blood flows were measured with Doppler ultrasonic and electromagnetic flowmeters. In normal dogs, prior to cholinergic blockade, ouabain caused early increases in mesenteric, renal, and external iliac resistances but later, between 15 and 30 minutes, mesenteric resistance decreased below the control level while renal and external iliac resistances remained elevated. After cholinergic blockade, the ouabain-induced alterations in renal and iliac resistance were unaltered, but the later decline in resistance in the mesenteric bed was reversed, resulting in sustained constriction. The late decline in mesenteric resistance also was not observed in the conscious animal after the injection of ouabain, 5 µg/kg, directly into the mesenteric artery or in the majority of dogs given ouabain intravenously after having been anesthetized with pentobarbital sodium. In the conscious dogs with heart failure, ouabain resulted in increased renal and iliac resistances initially, and in vasodilatation later while mesenteric resistance fell initially and remained below control for the entire 30 minutes. Thus, in the normal conscious dog, ouabain causes vasoconstriction in the regional vascular beds, apparently by its direct vascular action, and, in addition, a cholinergically mediated vasodilatation in the mesenteric bed. In the conscious dog with heart failure, ouabain increases blood flow to all beds, reducing the compensatory vasoconstriction of the low output state.

Effects of cardiac depression and of anesthesia on the myocardial action of a cardiac glycoside

The effects of ouabain (G-strophanthin) 20 mug/kg, on left ventricular (LV) pressure (P), diameter (D), velocity of contraction (dD/dt), and dP/dt were studied in conscious dogs instrumented with ultrasonic diameter gauges and miniature pressure gauges. The effects of ouabain were compared on separate occasions in the same dogs after cardiac depression with propranolol, 3.0 mg/kg, and also after general anesthesia with Na pentobarbital, 30 mg/kg. Maximal pressor effects were observed in the first 10 min, but maximal effects on the contractile state occurred at 30 min after ouabain. At this time, in conscious dogs, ouabain had increased LV isolength systolic pressure by 5%, LV isolength velocity by only 9%, and LV (dP/dt)/P by 21%, while end systolic diameter (ESD) decreased slightly and end diastolic diameter (EDD) and heart rate (HR) were unchanged. After anesthesia, ouabain increased LV systolic pressure by 8%, velocity 32%, (dP/dt)/P by 47%, and ESD decreased by 1.2 mm while EDD rose slightly and HR fell by 26 beats/min. Returning HR to control with atrial pacing decreased EDD 0.9 mm below control. After cardiac depression with propranolol, ouabain caused responses similar to those observed in the anesthetized dogs. Thus, the cardiac glycoside was found to exert only minor inotropic effects on the nonfailing heart of conscious dogs but far more striking inotropic responses in the anesthetized state.

Effects of a digitalis glycoside on coronary and systemic dynamics in conscious dogs

The effects of ouabain (G-strophanthin), 20 µg/kg were compared in 12 conscious dogs with Doppler flow transducers on the ascending aorta and left circumflex coronary artery and pressure gauges in the aorta, and in 9 of these dogs after general anesthesia with Na pentobarbital. In conscious dogs ouabain caused an initial bradycardia, but heart rate returned almost to control at 15 to 30 minutes, while arterial pressure rose and remained elevated. Cardiac output and coronary blood flow decreased initially, returned to control by 5 minutes and then remained constant. Systemic, mean, and late diastolic coronary resistances were elevated within 1 minute and remained elevated for 30 minutes. After anesthesia, ouabain caused similar increases in arterial pressure and slightly greater increases in systemic resistance, but the bradycardia and reduction of cardiac output were more profound and sustained. In the anesthetized state, coronary resistance rose when heart rate was allowed to slow after ouabain but was not elevated when heart rate was returned to control. Thus, in the conscious state, ouabain caused a distinct elevation in coronary and systemic resistances with no change in cardiac output, while in the anesthetized state ouabain reduced cardiac output and when heart rate was controlled, did not alter coronary resistance.