Myocardial microvascular permeability, interstitial oedema, and compromised cardiac function.
The heart, perhaps more than any other organ, is exquisitely sensitive to increases in microvascular permeability and the accumulation of myocardial interstitial oedema fluid. Whereas some organs can cope with profound increases in the interstitial fluid volume or oedema formation without a compromise in function, heart function is significantly compromised with only a few percent increase in the interstitial fluid volume. This would be of little consequence if myocardial oedema were an uncommon pathology. On the contrary, myocardial oedema forms in response to many disease states as well as clinical interventions such as cardiopulmonary bypass and cardioplegic arrest common to many cardiothoracic surgical procedures. The heart's inability to function effectively in the presence of myocardial oedema is further confounded by the perplexing fact that the resolution of myocardial oedema does not restore normal cardiac function. We will attempt to provide some insight as to how microvascular permeability and myocardial oedema formation compromise cardiac function and discuss the acute changes that might take place in the myocardium to perpetuate compromised cardiac function following oedema resolution. We will also discuss compensatory changes in the interstitial matrix of the heart in response to chronic myocardial oedema and the role they play to optimize myocardial function during chronic oedemagenic disease.
Dongaonkar
Ranjeet M
RM
Michael E. DeBakey Institute, Texas A&M University, College Station, TX 77843-4466, USA.
Stewart
Randolph H
RH
Geissler
Hans J
HJ
Laine
Glen A
GA
D000818:Animals; D001826:Body Fluids / Q000378:metabolism*; D002199:Capillary Permeability; D003331:Coronary Vessels / Q000378:metabolism* / Q000503:physiopathology; D003952:Diagnostic Imaging / Q000379:methods; D004489:Edema, Cardiac / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D055806:Microvessels / Q000378:metabolism* / Q000503:physiopathology; D008955:Models, Cardiovascular; D009200:Myocardial Contraction; D009206:Myocardium / Q000378:metabolism*; D011237:Predictive Value of Tests; D015398:Signal Transduction; D016276:Ventricular Function
Am J Physiol Heart Circ Physiol. 2008 Jun;294(6):H2428-34
18375722
J Gen Physiol. 1964 Mar;47:667-77
14127605
Circ Res. 1987 Aug;61(2):203-8
3621486
J Trauma. 1992 Jun;32(6):686-92
1613827
Prog Cardiovasc Dis. 1988 Jul-Aug;31(1):17-38
3293118
Circ Res. 1988 Jul;63(1):87-96
2968195
Basic Res Cardiol. 1976 May-Jun;71(3):263-9
938438
Am J Physiol. 1994 Sep;267(3 Pt 2):H1054-61
8092270
J Appl Physiol (1985). 1995 Jan;78(1):132-7
7713802
J Thorac Cardiovasc Surg. 1998 May;115(5):1209-14
9605093
Cardiovasc Surg. 1998 Jun;6(3):274-81
9705100
J Clin Invest. 1993 Nov;92(5):2303-12
8227345
J Surg Res. 1994 Dec;57(6):641-6
7996839
Anesth Analg. 1997 Nov;85(5):987-92
9356088
J Am Coll Cardiol. 2009 Apr 7;53(14):1194-201
19341860
Circ Res. 1991 Jun;68(6):1713-21
2036720
J Physiol. 1981;319:311-23
6798198
Cancer Res. 1975 May;35(5):1164-7
1120306
Am Rev Respir Dis. 1989 Mar;139(3):682-7
2923370
Circ Res. 1988 May;62(5):953-60
3359578
Microcirculation. 1996 Dec;3(4):371-8
9086448
J Thorac Cardiovasc Surg. 1992 Mar;103(3):504-13
1545549
Am J Physiol. 1986 Nov;251(5 Pt 2):H1090-4
3777196
Circ Res. 1991 Sep;69(3):561-70
1873859
Magn Reson Med. 2007 May;57(5):891-7
17457880
Am J Physiol. 1995 Jan;268(1 Pt 2):H178-83
7840262
Circulation. 1977 Jan;55(1):99-108
851470
Ultrasound Med Biol. 2000 Mar;26(3):375-84
10773367
N Engl J Med. 1981 Feb 26;304(9):497-503
7453783
Am J Physiol. 1996 Sep;271(3 Pt 2):H834-41
8853315
Am J Cardiol. 1983 Jul;52(1):184-8
6858909
Circulation. 1993 Aug;88(2):726-35
8339433
Ann Thorac Surg. 1996 Sep;62(3):737-43
8784001
Circ Shock. 1992 Jan;36(1):45-56
1372536
Chest. 1997 Sep;112(3):676-92
9315800
Microcirculation. 2000 Aug;7(4):269-80
10963632
Am J Physiol Heart Circ Physiol. 2002 Apr;282(4):H1270-7
11893561
J Physiol. 1896 May 5;19(4):312-26
16992325
Am J Physiol. 1977 Aug;233(2):H295-8
888972
Circ Res. 1971 Aug;29(2):181-207
4935840
J Clin Invest. 1991 Nov;88(5):1622-8
1939649
Am J Physiol. 1996 Dec;271(6 Pt 2):R1465-9
8997340
Am J Physiol. 1997 Sep;273(3 Pt 2):H1408-14
9321832
Crit Care Med. 2006 Jan;34(1):127-33
16374166
Pflugers Arch. 2000 Sep;440(5):653-66
11007304
N Engl J Med. 1993 May 20;328(20):1471-7
8479467
Bibl Anat. 1975;13:24-7
1231735
J Thorac Cardiovasc Surg. 1998 May;115(5):1189-95
9605090
Am J Physiol. 1985 Oct;249(4 Pt 2):H834-42
4051019
Am J Cardiol. 1971 Oct;28(4):463-6
5095934
Am Heart J. 1991 Sep;122(3 Pt 1):655-64
1877442
Am J Physiol. 1975 Sep;229(3):838-46
129013
Basic Res Cardiol. 1982 Mar-Apr;77(2):158-69
7092774
Crit Care Med. 2010 Mar;38(3):861-70
20168148
Am J Physiol. 1998 Mar;274(3):H937-44
9530207
Physiol Rev. 2006 Jan;86(1):279-367
16371600
Circulation. 1995 Oct 1;92(7):1940-6
7671379
Physiol Rev. 1993 Jan;73(1):1-78
8419962
Jpn J Physiol. 1979;29(1):1-13
449120
JACC Cardiovasc Imaging. 2009 Oct;2(10):1167-74
19833305
Ann Thorac Surg. 1999 Sep;68(3):925-30
10509985
Semin Thorac Cardiovasc Surg. 2008 Winter;20(4):374-9
19251179
Thorac Cardiovasc Surg. 2001 Aug;49(4):199-203
11505314
Lymphology. 1972 Dec;5(4):156-60
4647281
J Exp Med. 1928 Jan 31;47(2):273-90
19869413
J Cardiovasc Magn Reson. 2009 Dec 30;11:56
20042111
Circ Res. 1989 Dec;65(6):1657-64
2582594
Am J Physiol Regul Integr Comp Physiol. 2008 Feb;294(2):R651-9
18056984
J Thorac Cardiovasc Surg. 1993 Oct;106(4):651-7
8412259
Am J Physiol. 1990 Mar;258(3 Pt 2):H748-53
2316690
J Thorac Cardiovasc Surg. 1977 Jan;73(1):129-38
831003