Systolic and diastolic left ventricular dysfunction due to mild hypothermia.
Postoperative cardiac patients frequently are mildly hypothermic, yet the influence of hypothermia on left ventricular (LV) contractility has received little attention. To study the possible effects of mild hypothermia on LV function, six pigs were placed on partial right ventricular bypass, the hearts were electrically paced to control heart rate, and myocardial temperature was varied between 34 degrees and 38 degrees C. Using two pairs of orthogonally oriented sonomicrometer crystals in the left anterior descending (LAD) and left circumflex (LCX) distributions, we estimated regional work (the area within LV pressure-area loops) over a range of LV preloads. Diastolic function was assessed by measurement of the time constant of LV pressure decay during isovolumic relaxation. Regional work data were expressed as percentages of baseline (38 degrees C and end-diastolic pressure of 10 mm Hg). To control for preload variations, regional work and time constants were calculated from beats with end-diastolic areas within 0.1% of baseline. Regional work (mean +/- SEM) declined from 85.1 +/- 6.7% at 38 degrees C to 31.9 +/- 4.4% at 34 degrees C. Time constants were prolonged from 44.8 +/- 2.5 msec at 38 degrees C to 61.6 +/- 2.7 msec at 34 degrees C. These data demonstrate a marked depression of LV contractility, even at mild levels of hypothermia that may be encountered clinically after cardiac operations.
Greene
P S
PS
Division of Cardiac Surgery, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Cameron
D E
DE
Mohlala
M L
ML
Dinatale
J M
JM
Gardner
T J
TJ
D000818:Animals; D001831:Body Temperature / Q000502:physiology; D007035:Hypothermia / Q000503:physiopathology*; D007036:Hypothermia, Induced; D009200:Myocardial Contraction / Q000502:physiology*; D011183:Postoperative Complications / Q000209:etiology; D013552:Swine