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Dynamic effects of positive-pressure ventilation on canine left ventricular pressure-volume relations

Denault, AY and Gorcsan, J and Pinsky, MR (2001) Dynamic effects of positive-pressure ventilation on canine left ventricular pressure-volume relations. Journal of Applied Physiology, 91 (1). 298 - 308. ISSN 8750-7587

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Positive-pressure ventilation (PPV) may affect left ventricular (LV) performance by altering both LV diastolic compliance and pericardial pressure (Ppc). We measured the effect of PPV on LV intraluminal pressure, Ppc, LV volume, and LV cross-sectional area in 17 acute anesthetized dogs. To account for changes in lung volume independent of changes in Ppc and differences in contractility, measures were made during both open- and closed-chest conditions, during closed chest with and without chest wall binding, and after propranolol-induced acute ventricular failure (AVF). Apneic end-systolic pressure-volume relations (ESPVR) were generated by inferior vena caval occlusions. With the open chest, PPV had no effects. With the chest closed, PPV inspiration decreased LV end-diastolic volume (EDV) along its diastolic compliance curve and decreased end-systolic volume (ESV) such that the end-systolic pressure-volume domain was shifted to a point left of the LV ESPVR, even when referenced to Ppc. The decrease in EDV was greater in control than in AVF conditions, whereas the shift of the ESV to the left of the ESPVR was greater with AVF than in control conditions. We conclude that the hemodynamic effects of PPV inspiration are due primarily to changes in intrathoracic pressure and that the inspiration-induced decreases of LV EDV reflect direct effects of intrathoracic pressure on LV filling. The decreases in LV ESV exceed the amount explained solely by a reduction in LV ejection pressure.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Denault, AY
Gorcsan, Jgorcsan@pitt.eduGORCSAN
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 January 2001
Date Type: Publication
Journal or Publication Title: Journal of Applied Physiology
Volume: 91
Number: 1
Page Range: 298 - 308
DOI or Unique Handle: 10.1152/jappl.2001.91.1.298
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 8750-7587
PubMed ID: 11408444
Date Deposited: 20 Mar 2012 16:08
Last Modified: 22 Jun 2020 14:55


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