VENTRICULAR FUNCTION DURING CARDIAC SURGERY

心脏手术期间的心室功能

• 批准号: 2224159
• 负责人: HENRY Michael SPOTNITZ
• 金额: $ 28.59万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-05-01 至 1996-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2224159
• 关键词: adolescence (12-20); adult human (21+); angiocardioultrasonography; child (0-11); congenital heart disorder; coronary bypass; coronary disorder; echocardiography; health care cost /financing; heart circulation; heart contraction; heart function; heart surgery; heart valve transplantation; heart ventricle; human subject; infant human (0-1 year); intracardiac volume; longitudinal human study; mitral valve stenosis; patient care management; tetralogy of Fallot

These studies will examine the effect of surgical correction of acquired and congenital heart disease on the systolic and diastolic properties of the left and right ventricles in human adults, children, and infants. State of the art measuring devices and algorithms will be employed for intraoperative measurements and long-term follow-up. Improved pump function during corrective surgery will be correlated with changes in myocardial properties, since impaired contractility and compliance can be hidden by improved hemodynamics. For specific operations in which the pathophysiology of surgical correction is not well understood, specific mechanisms that promote a successful long term result will be defined. Outpatient studies will examine chronic changes in ventricular size and function, which will be related to intraoperative events. Laboratory studies will develop advanced methods for intraoperative study and reduce the cost of such studies, making the technology widely available. Intraoperative measurements will include pressure by micromanometer, flow by electromagnetic or ultrasonic flowmeter, and dimensions by sonomicrometry, two-dimensional echocardiography, and ventricular impedance. End-diastolic volume will be correlated with end-diastolic pressure to measure compliance, and with pressure-volume stroke work to measure contractile function (preload recruitable stroke work). Contractility will also be measured from pressure-volume loops (end- systolic pressure-volume relation). End-diastolic pressure-ventricular performance relations will also be measured, since these directly influences patient symptoms. These goals will be accomplished by a dedicated faculty with the right combination of clinical experience and laboratory background to conduct these studies effectively and safely. Results will improve care of patients undergoing cardiac surgery, will clarify deficiencies of current management, will expand understanding of the pathophysiology of heart surgery, and will make low cost methods for the study of systolic and diastolic properties generally available to cardiac surgeons and laboratory scientists.

这些研究将检查手术矫正后天性 和先天性心脏病对心脏收缩和舒张功能的影响 成人、儿童和婴儿的左右心室。 将采用最先进的测量设备和算法， 术中测量和长期随访。 改进的泵 矫正手术期间的功能将与 心肌特性，因为受损的收缩性和顺应性可以 被改善的血液动力学所掩盖。 对于特定操作， 手术矫正的病理生理学尚未得到很好的理解， 将确定促进取得成功的长期成果的机制。 门诊研究将检查心室大小的慢性变化， 功能，这将与术中事件有关。 实验室 研究将开发先进的术中研究方法， 这些研究的成本，使技术广泛使用。 术中测量将包括微压计压力、流量 通过电磁或超声波流量计， 超声测微法、二维超声心动图和心室 阻抗 舒张末期容积将与舒张末期 压力测量顺应性，并与压力-容积冲程功， 测量收缩功能（预负荷可恢复的每搏功）。 收缩力也将从压力-容积环（末端-末端）测量。 收缩压-容积关系）。 舒张末期心室压 业绩关系也将得到衡量，因为这些直接 影响患者症状。 这些目标将通过一个 专业的教师与临床经验的正确组合， 实验室背景，以有效和安全地进行这些研究。 结果将改善心脏手术患者的护理， 澄清当前管理的不足，将扩大对 心脏手术的病理生理学，并将使低成本的方法， 收缩和舒张特性的研究通常可用于 心脏外科医生和实验室科学家。