Abstract
1. Beat-by-beat changes in left ventricular stroke volume (l.v.s.v.) with breathing were recorded in four normal subjects using pulsed Doppler ultrasound. The l.v.s.v. fell during inspiration and rose during expiration; these changes were exaggerated at high tidal volumes. 2. Respiratory changes in l.v.s.v. persisted when respiratory rate was increased to 25 breaths/min despite an associated reduction in the degree of sinus arrhythmia. 3. During relaxed breath-holding, respiratory variations in l.v.s.v. ceased immediately, and on resumption of breathing a significant fall in l.v.s.v. occurred with the first inspiratory effort. 4. Inspiratory efforts against an occluded mouthpiece were accompanied by significant variations in l.v.s.v., although the magnitude of these changes was smaller than during unoccluded breathing with similar pleural pressure changes. 5. A resistive inspiratory load increased the respiratory variations in l.v.s.v. in the three subjects studied. 6. In three patients with implanted dual-chamber pacemakers set to constant heart rates, breathing was associated with larger variations in l.v.s.v. 7. In two patients who had undergone pericardectomy, the magnitude of respiratory changes in l.v.s.v. was less than in the normal subjects. 8. We conclude that inspiration directly lowers l.v.s.v. in man by a direct mechanism which is largely independent of lung volume changes, is dependent on changes in pleural pressure, and persists in the absence of sinus arrhythmia. All these results, particularly those in pericardectomy patients, are compatible with previous animal work on the anatomical and functional interdependence of right and left ventricles during breathing.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brinker J. A., Weiss J. L., Lappé D. L., Rabson J. L., Summer W. R., Permutt S., Weisfeldt M. L. Leftward septal displacement during right ventricular loading in man. Circulation. 1980 Mar;61(3):626–633. doi: 10.1161/01.cir.61.3.626. [DOI] [PubMed] [Google Scholar]
- Farthing S., Peronneau P. Flow in the thoracic aorta. Cardiovasc Res. 1979 Nov;13(11):607–620. doi: 10.1093/cvr/13.11.607. [DOI] [PubMed] [Google Scholar]
- Fisher D. C., Sahn D. J., Friedman M. J., Larson D., Valdes-Cruz L. M., Horowitz S., Goldberg S. J., Allen H. D. The effect of variations of pulsed Doppler sampling site on calculation of cardiac output: an experimental study in open-chest dogs. Circulation. 1983 Feb;67(2):370–376. doi: 10.1161/01.cir.67.2.370. [DOI] [PubMed] [Google Scholar]
- Gabe I. T., Gault J. H., Ross J., Jr, Mason D. T., Mills C. J., Schillingford J. P., Braunwald E. Measurement of instantaneous blood flow velocity and pressure in conscious man with a catheter-tip velocity probe. Circulation. 1969 Nov;40(5):603–614. doi: 10.1161/01.cir.40.5.603. [DOI] [PubMed] [Google Scholar]
- HARRISON D. C., GOLDBLATT A., BRAUNWALD E., GLICK G., MASON D. T. STUDIES ON CARDIAC DIMENSIONS IN INTACT, UNANESTHETIZED MAN. I. DESCRIPTION OF TECHNIQUES AND THEIR VALIDATION. II. EFFECTS OF RESPIRATION. III. EFFECTS OF MUSCULAR EXERCISE. Circ Res. 1963 Nov;13:448–467. doi: 10.1161/01.res.13.5.448. [DOI] [PubMed] [Google Scholar]
- Hoffman J. I., Guz A., Charlier A. A., Wilcken D. E. Stroke volume in conscious dogs; effect of respiration, posture, and vascular occlusion. J Appl Physiol. 1965 Sep;20(5):865–877. doi: 10.1152/jappl.1965.20.5.865. [DOI] [PubMed] [Google Scholar]
- Innes J. A., Mills C. J., Noble M. I., Murphy K., Pugh S., Shore A. C., Guz A. Validation of beat by beat pulsed Doppler measurements of ascending aortic blood velocity in man. Cardiovasc Res. 1987 Jan;21(1):72–80. doi: 10.1093/cvr/21.1.72. [DOI] [PubMed] [Google Scholar]
- Jenni R., Vieli A., Ruffmann K., Krayenbuehl H. P., Anliker M. A comparison between single gate and multigate ultrasonic Doppler measurements for the assessment of the velocity pattern in the human ascending aorta. Eur Heart J. 1984 Nov;5(11):948–953. doi: 10.1093/oxfordjournals.eurheartj.a061596. [DOI] [PubMed] [Google Scholar]
- Karam M., Wise R. A., Natarajan T. K., Permutt S., Wagner H. N. Mechanism of decreased left ventricular stroke volume during inspiration in man. Circulation. 1984 May;69(5):866–873. doi: 10.1161/01.cir.69.5.866. [DOI] [PubMed] [Google Scholar]
- MILIC-EMILI J., MEAD J., TURNER J. M., GLAUSER E. M. IMPROVED TECHNIQUE FOR ESTIMATING PLEURAL PRESSURE FROM ESOPHAGEAL BALLOONS. J Appl Physiol. 1964 Mar;19:207–211. doi: 10.1152/jappl.1964.19.2.207. [DOI] [PubMed] [Google Scholar]
- Robotham J. L., Lixfeld W., Holland L., MacGregor D., Bryan A. C., Rabson J. Effects of respiration on cardiac performance. J Appl Physiol Respir Environ Exerc Physiol. 1978 May;44(5):703–709. doi: 10.1152/jappl.1978.44.5.703. [DOI] [PubMed] [Google Scholar]
- Robotham J. L., Mintzner W. A model of the effects of respiration on left ventricular performance. J Appl Physiol Respir Environ Exerc Physiol. 1979 Mar;46(3):411–418. doi: 10.1152/jappl.1979.46.3.411. [DOI] [PubMed] [Google Scholar]
- Robotham J. L., Rabson J., Permutt S., Bromberger-Barnea B. Left ventricular hemodynamics during respiration. J Appl Physiol Respir Environ Exerc Physiol. 1979 Dec;47(6):1295–1303. doi: 10.1152/jappl.1979.47.6.1295. [DOI] [PubMed] [Google Scholar]
- Scharf S. M., Brown R., Saunders N., Green L. H. Effects of normal and loaded spontaneous inspiration on cardiovascular function. J Appl Physiol Respir Environ Exerc Physiol. 1979 Sep;47(3):582–590. doi: 10.1152/jappl.1979.47.3.582. [DOI] [PubMed] [Google Scholar]
- Stalcup S. A., Mellins R. B. Mechanical forces producing pulmonary edema in acute asthma. N Engl J Med. 1977 Sep 15;297(11):592–596. doi: 10.1056/NEJM197709152971107. [DOI] [PubMed] [Google Scholar]