Ventricular Function During Cardiac Surgery

描述（由申请人提供）：这些研究将检查 先天性和后天性心脏病的外科治疗 以及成年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 可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还不清楚， 将确定一个成功的长期结果。门诊研究将 检查心室大小和功能的慢性变化，这将与 手术中的事件。实验室研究将开发先进的方法， 术中研究和降低此类研究的成本， 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及尺寸 通过超声测微法、二维超声心动图和心室 电导舒张末期容积将与舒张末期 压力测量顺应性，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（收缩末期压力-容积关系）测量。 还将测量舒张末期压-心室性能关系， 因为它们直接影响患者的症状。这些目标将是 由一个专门的教师与临床的正确组合完成 有效开展此类研究的经验和实验室背景， 平安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，并将为研究提供低成本的方法 心脏外科医生通常可以获得的收缩和舒张特性 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.