Ventricular Function During Cardiac Surgery

描述(由申请者提供)：这些研究将检验 后天性和先天性心脏病心脏收缩功能的外科矫正 以及成人左、右室的舒张期特性， 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 矫正手术中泵功能的变化将与 心肌特性，因为收缩和顺应性受损可以 被改善的血流动力学所掩盖。用于特定的操作，其中 手术矫正的病理生理学还不是很清楚，机制是 促进一个成功的长期结果将被定义。门诊研究将 检查脑室大小和功能的慢性变化，这与 对术中事件的反应。实验室研究将开发先进的方法 术中研究并降低此类研究的成本，使技术 随处可见。术中测量将包括 电磁或超声波流量计微压计和尺寸 通过声学显微测量、二维超声心动图和心脏 电导。舒张末容量将与舒张末相关 用压力来测量顺应性，并用压力-体积行程来测量 收缩功能(预负荷可恢复的卒中功)。伸缩性也将 从压力-体积环(收缩末期压力-体积关系)测量。 还将测量舒张末压力-心室性能关系， 因为这些会直接影响患者的症状。这些目标将是 由敬业的教师与正确的临床组合完成 有效地进行此类研究的经验和实验室背景以及 安全无恙。结果将改善心脏手术患者的护理 澄清当前管理中的不足，将扩大对 心脏手术的病理生理学，并将为研究提供低成本的方法 心脏外科医生通常可获得的收缩和舒张期特性 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.