Cesar A. Castillo

Left Ventricular Function in Chronic Obstructive Lung Disease

Abstract In 15 patients with chronic obstructive lung disease, biventricular cardiac catheterization showed that left ventricular end-diastolic pressure was elevated in seven, and abnormal left ventricular function curves were found in 14. Analysis of left ventriculography revealed increased wall thickness or diastolic chamber size (or both) in nine of 10 observations and impaired ventricular performance in three of eight. The degree of functional impairment was not influenced by the presence or absence of right-sided heart failure. Appreciable coronary narrowing was found in only two of 10 subjects studied by cineangiography. Left ventricular dysfunction was present in most of the patients studied. The pathogenesis of the dysfunction is not clear.

A STUDY IN MAN OF CEREBRAL BLOOD FLOW AND CEREBRAL GLUCOSE, LACTATE AND PYRUVATE METABOLISM BEFORE AND AFTER EATING*

It has been shown that subjective feelings of hunger (1) and even objective phenomena such as gastric hunger contractions (2) can be correlated with a decreased arteriovenous glucose difference across the forearm. This decrease in arteriovenous difference of glucose was thought to indicate a decreased rate of glucose utilization by peripheral tissues and its role in hunger regulation has recently been reviewed by Mayer (3, 4). Since the brain is particularly dependent on glucose for metabolism it would be of interest to determine its response to the fasting state and the ingestion of a test meal. If, in the fasting state, such decreased utilization of glucose occurs in the brain as does peripherally, it would be of interest to know what other carbohydrate substances are utilized and particularly whether or not variation in the amount of glucose taken up by the cerebral tissue is related to the sensation of hunger.

CORONARY BLOOD FLOW AND MYOCARDIAL OXIDATIVE METABOLISM AT REST AND DURING EXERCISE IN SUBJECTS WITH SEVERE AORTIC VALVE DISEASE.

AVAILABLE data concerning coronary flow in intact human subjects have indicated that there is a strong tendency for the blood flow per unit weight of myocardium to fall in the usual range under a wide variety of circumstances and for the coronary vessels to be capable of adapting themselves to most situations sufficiently well to maintain usual coronary flow as long as myocardial metabolism is not deranged. When myocardial metabolism is deranged, the coronary circulation adapts to these derangements as, for example, in thyrotoxicosis2 and thiamine deficiency.3 The question of adaptation of human coronary flow to mechanical interference prompted the present study of coronary blood flow in subjects with aortic valve disease because of the following considerations. The best current estimates from animal studies indicate that the major portion of coronary flow occurs during diastole, even though flow during systole is considerable.4 It has been emphasized repeatedly, however, that the time of flow into the coronary arteries, as measured by a flowmeter near their aortic origin, may bear little if any relation to flow through the capillary bed and circulatory exchange within the myocardium. Indeed, blood flow out of the coronary sinus is maximal during systole4 and hence during passage through the myocardium the phase of flow shifts 180 degrees. The nitrous oxide meth-

A HEMODYNAMIC STUDY OF HYPERTENSION INCLUDING OBSERVATIONS ON CORONARY BLOOD FLOW

Excerpt Many studies of the systemic hemodynamics of arterial hypertension have been done, both in the experimental animal and in man, and these have recently been reviewed by Fries.1The specific d...

The systemic and coronary hemodynamic effects of synthetic bradykinin.

Abstract 1. The systemic and coronary hemodynamic effects of bradykinin have been studied during its infusion into anesthetized dogs. 2. The administration of bradykinin is associated with decreased peripheral, pulmonary, and coronary vascular resistance, accompanied by systemic arterial hypotension. 3. Cardiac output increased, and coronary blood flow increased in those animals with a normal or low resting coronary flow and decreased in those with high resting coronary blood flow. 4. The depletion of catecholamine, through the administration of reserpine, does not change the response basically, although it is modified slightly.

SEROTONIN AND THE DYNAMICS OF THE HEART

Page created the term amphibaric to describe the effects of serotonin upon cardiovascular hemodynamics, the implication being that their trend and magnitude vary with the species, the site of injection, and the dose. In line with this, the present report describes the effects of serotonin upon systemic, pulmonary, and coronary hemodynamics and metabolism in the intact, lightly anesthetized dog. The experiments, directed by George Maxwell, constitute a preliminary report on a larger scale serotonin study still in progress.2

Comparison of Systemic and Coronary Hemodynamics in the Normal Human Male and Female

Coronary and systemic hemodynamics were compared in 15 normal men and 15 normal women. Systemic hemodynamics were very similar. The women had 26.5 per cent greater coronary flow and 19.6 per cent more oxygen consumption/100 Gm. of left ventricular myocardium. Their calculated coronary vascular resistance was 35 per cent less. Significant negative correlations between coronary flow and calculated heart weight, and between cardiac oxygen consumption and calculated heart weight, as well as between coronary flow and hematocrit probably explain the differences in part. Whether hormonal or anatomic differences are also significant is not known.

Simulated shunt curves

Abstract A simple method for simulating indicator-dilution curves produced by shunts in intact dog is described. Simulated right to left shunts of about 2.5 per cent can be clearly detected in peripheral arterial dilution curves. A larger simulated left to right shunt was required to produce clear-cut distortion of the systemic arterial indicator-dilution curve. For detection of a small left to right shunt, sampling from both the pulmonary and the femoral artery simultaneously gives indicator-dilution curves which are much more sensitive.

Hemodynamics of Mitral Stenosis with Special Reference to Coronary Blood Flow and Myocardial Oxygen Consumption

A LTHOUGH there are excellent articles concerning the clinical and hemodynamic features of mitral stenosis,1-3 information concerning the coronary blood flow and the myocardial metabolism of oxygen and carbon dioxide in such subjects is inadequate. This report describes hemodynamic observations in 20 female subjects with mitral stenosis who underwent cardiac catheterization with determinations of the cardiac output and coronary blood flow.

Acute systemic and coronary hemodynamic effects of chlorothiazide in subjects with systemic arterial hypertension

Abstract 1. 1. The acute systemic and coronary hemodynamic effects of intravenous administration of chlorothiazide are reported in 9 hypertensive subjects. 2. 2. There was a significant decrease in the central venous pressure and pulmonary artery pressure accompanied by decreased cardiac output and reduced right and left ventricular work. 3. 3. Coronary blood flow decreased slightly, but not significantly, and the coronary sinus blood oxygen content was maintained.