Ventricular Function During Cardiac Surgery

描述（由申请人提供）：这些研究将检验以下效果： 获得性和先天性心脏病收缩压的手术矫正 以及成人左心室和右心室的舒张特性， 儿童和婴儿。最先进的测量设备和算法将 用于术中测量和长期随访。改进 矫正手术期间的泵功能将与 心肌特性，因为收缩力和顺应性受损可能会 被改善的血流动力学所隐藏。对于具体操作，其中 手术矫正的病理生理学尚不清楚，其机制 促进成功的长期结果将被定义。门诊研究将 检查心室大小和功能的慢性变化，这与 术中事件。实验室研究将开发先进方法 术中研究并降低此类研究的成本，使该技术 广泛可用。术中测量将包括压力 微压计、电磁流量计或超声波流量计的流量以及尺寸 通过超声心动图、二维超声心动图和心室 电导。舒张末期容积与舒张末期相关 压力来测量顺应性，并用压力-容积冲程功来测量 收缩功能（预加载可复张冲程功）。收缩性也会 通过压力-容积环（收缩末期压力-容积关系）进行测量。 还将测量舒张末压-心室性能关系， 因为这些直接影响患者的症状。这些目标将是 由专门的教师通过正确的临床组合完成 experience and laboratory background to conduct such studies effectively and 安全。结果将改善接受心脏手术的患者的护理， 澄清当前管理的缺陷，将扩大对 心脏手术的病理生理学，并将为研究提供低成本方法 of systolic and diastolic properties generally available to cardiac surgeons 和实验室科学家。

DESCRIPTION (Provided by Applicant): 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 followup. 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, 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 conductance. 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 such 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.