-transparent.png){kind=logo}
BACKGROUND Impairment of left ventricular function after cardiopulmonary bypass (CPB) is well recognized, but little is known about the time course of recovery of cardiac function early after separation from CPB. Therefore, recovery of left ventricular function was evaluated early after separation from CPB in patients undergoing coronary artery surgery. The authors tried to determine whether this recovery might be attributed to autoregulation of function by preload. METHODS Left ventricular pressure was measured with fluid-filled catheters. Data were digitally recorded during increased pressure induced by elevating the legs. Transgastric short-axis echocardiographic views of the left ventricle were simultaneously recorded on videotape. Systolic function was evaluated with the slope (Ees, mmHg/ml) of the systolic pressure-volume relation. Diastolic function was evaluated with the chamber stiffness constant (Kc, ml-1) of the diastolic pressure-volume relation. Cardiac function was assessed before CPB, after termination of CPB, and 5, 10, and 15 min later. Two different separation procedures from CPB were compared: in protocol 1, left ventricular function was documented during the standard procedure (n = 24); in protocol 2, the heart was optimally filled 10 min before separation from CPB (n = 12). RESULTS In protocol 1, Ees was 2.88 +/- 0.21 mmHg/ml (mean +/- SEM) and Kc was 0.012 +/- 0.001 ml-1 before CPB. Within 10 min after separation from CPB, Ees increased from 1.10 +/- 0.32 to 2.92 +/- 0.34 (P = 0.001) and Kc decreased from 0.022 +/- 0.002 to 0.011 +/- 0.001 (P = 0.001). The parameters remained stable thereafter. In protocol 2, Ees was 2.92 +/- 0.51 mmHg/ ml and Kc was 0.011 +/- 0.002 ml-1 before CPB. Depression of systolic and diastolic function was not observed in these patients. At time 0, Ees was 2.46 +/- 0.16 and Kc was 0.012 +/- 0.002. These values remained stable throughout the entire observation period. CONCLUSIONS Significant functional recovery was observed early after separation from CPB, which was suggestive of time-dependent changes in both systolic and diastolic left ventricular function induced by preload restoration.
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
February 1998,
The Journal of thoracic and cardiovascular surgery,
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
January 2018,
Journal of cardiovascular echography,
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
February 1995,
The Annals of thoracic surgery,
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
April 2005,
Orvosi hetilap,
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
November 1990,
Critical care medicine,
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
October 2001,
Clinical cardiology,
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
December 1982,
American heart journal,
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
June 2016,
Circulation. Cardiovascular interventions,
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
August 2016,
Journal of cardiothoracic and vascular anesthesia,
S G De Hert, and
I E Rodrigus, and
L R Haenen, and
P A De Mulder, and
T C Gillebert
June 1984,
Journal of the American College of Cardiology,
