[The effects of left ventricular distention on coronary blood flow and myocardial metabolism during cardiopulmonary bypass (author's transl)].
These studies show that distention of the fibrillating left ventricle during cardiopulmonary bypass impedes subendocardial flow and causes myocardial ischemia. While myocardial oxygen requirements increase when the heart becomes distended (La Place relationship) the elevated intracavitary pressure acts as a counterforce to subendocardial flow and prevents it from increasing sufficiently to meet these increased metabolic demands. The resultant ischemia is accentuated when the fibrillation is maintained electrically, since the fibrillating stimulus itself impedes subendocardial flow and causes ischemia.
D000818:Animals; D001794:Blood Pressure; D002315:Cardiopulmonary Bypass; D003326:Coronary Circulation; D003327:Coronary Disease / Q000209:etiology; D004195:Disease Models, Animal; D004285:Dogs; D005112:Extracorporeal Circulation; D006352:Heart Ventricles / Q000503:physiopathology*; D009206:Myocardium / Q000378:metabolism*; D010101:Oxygen Consumption; D014693:Ventricular Fibrillation / Q000097:blood / Q000503:physiopathology
Der Einfluss linksventrikulärer Druckerhöhung auf den Koronarfluss und den myokardialen Stoffwechsel bei extrakorporalem Kreislauf