Extrinsic factors influencing left ventricular conductance in situ.
BACKGROUND
The accuracy of conductance measurement of left ventricular (LV) volume is affected by parallel conductance (Vp) from right ventricular (RV) volume as well as surroundings of the heart. No studies have quantified the extrinsic influences on Vp.


RESULTS
In six anesthetized pigs, using a median sternotomy and pericardial well, implantable cardioverter defibrillator patches, normal saline, or echocardiography gel were introduced and removed. LV end-diastolic pressure (LVEDP) did not change significantly with these interventions. Raw LV conductance was used to estimate end-diastolic volume (LVEDV), end-systolic volume (LVESV), and stroke volume (SV). Saline significantly increased mean +/- SEM calculated LVEDV from 106 +/- 8 to 131 +/- 6 mL and calculated LVESV from 81 +/- 7 to 110 +/- 5 mL; calculated SV decreased from 25 +/- 3 to 21 +/- 2 mL (P < .05, paired t test). Implantable cardioverter defibrillator patches and gel did not significantly change calculated LV volumes. LV conductance was also measured in arrested hearts during LV filling (5 to 60 mL) at four levels of RV volume (RVV). Using a fixed value for Vp, calculated mean LV volume was 30 +/- 3 mL at RVV = 0, 32 +/- 3 mL at RVV = 20, 33 +/- 3 mL at RVV = 40, and 36 +/- 3 mL at RVV = 60 (P < .01, repeated-measures ANOVA).


CONCLUSIONS
While implantable cardioverter defibrillator patches and gel have no statistically significant effect, saline and RVV affect LV volume calculations by conductance, requiring special techniques during cardiopulmonary bypass or caval occlusion.
Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY 10032.
M M
MM
Amirhamzeh
C X
CX
Jia
H M
HM
Spotnitz
D000818:Animals; D006328:Cardiac Catheterization / Q000295:instrumentation; D017147:Defibrillators, Implantable; D004553:Electric Conductivity; D017097:Electric Impedance; D005782:Gels; D008297:Male; D012965:Sodium Chloride; D013318:Stroke Volume / Q000502:physiology*; D013552:Swine; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology
D005782:Gels; D012965:Sodium Chloride