Oxygen Consumption Measurements of the Myocardium in the Human Being

  • Christian J. F. Holubarsch
Part of the Basic Science for the Cardiologist book series (BASC, volume 10)

Abstract

One might argue that the best way to study myocardial energetics is to measure the myocardial oxygen consumption of patients and healthy subjects in vivo — possibly before and after an acute or chronic pharmacological intervention. Although this idea is intriguing, there is a number of limitations for such a procedure. (1) Such a kind of procedure is invasive and time-consuming, and therefore some ethical considerations come into play (see below). (2) In the whole organism, any inotropic or vasodilating pharmacological intervention is necessarily followed by reflex neuroendocrine mechanisms which make interpretations of altered myocardial oxygen consumption invalid or at least complicated. In order to overcome this problem, myocardial oxygen consumption must be considered in relation to the respective hemodynamic variables, i.e., stress-time integral, peak systolic stress, pressure-volume area, contraction velocity and others (see below). (3) Measurements of myocardial oxygen consumption — in contrast to hemodynamic measurements — need long periods of steady state conditions.

Keywords

Catheter Argon Cardiomyopathy Catecholamine Unistat 

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References

  1. 1).
    Bing RJ, Hammond MM, Handelman JC, Powers SR, Spencer FC, Eckenhoff JE, Goodale WT, Haffens HJ, Kety SS:The measurement of coronary blood flow, oxygen consumption and efficiency of the left ventricle in man. Am Heart J 1949;38:1–24PubMedCrossRefGoogle Scholar
  2. 2).
    Kern MJ, Donohue ThJ: Evaluation of myocardial blood flow and metabolism. In: Cardiac Catheterization, Angiography, and Intervention. Eds: Bairn DS, Grossmann W. Williams and Williams 1996;pp 359–389Google Scholar
  3. 3).
    Zeiher AM, Drexler H, Wollschläger H, Just H: Endothelial dysfunction of the coronary microvasculature is associated with impaired coronary flow regulation in patients with early atherosclerosis. Circulation 1991;84:1984–1992PubMedCrossRefGoogle Scholar
  4. 4).
    Ganz W, et al.: Measurements of coronary sinus blood flow by continuous thermodilution in man. Circulation 1971;44:181–191PubMedCrossRefGoogle Scholar
  5. 5).
    Baim DS, Rothman MT, Harrison DC: Improved catheter for regional coronary sinus flow and metabolic studies. Am J Cardiol 1980;46:997–1009PubMedCrossRefGoogle Scholar
  6. 6).
    Kety SS, Schmidt CF: The nitrous oxide method for the quantitative determination of cerebral blood flow in man: Theory, procedure and normal values. J Clin Invest 1948;27:476–483PubMedCrossRefGoogle Scholar
  7. 7).
    ) Bretschneider HJ, Gott L, Hilgert G, Probst R, Rau G: Gaschromatographische Trennung und Analyse von Argon als Basis einer neuen Fremdgasmethode zur Durchblutungsmessung von Organen. Verh Dtsch Ges Kreisl-Forsch 1966;32:267–273CrossRefGoogle Scholar
  8. 8).
    Rau G: Messung der Koronardurchblutung mit der Argon-Fremdgas-methode. Arch Kreisl-Forschung 1969;58:322–398CrossRefGoogle Scholar
  9. 9).
    Heiss HW, Blümchen G: Durchblutungsmessungen am Koronargefdßsystem. In: Reindell H, Roskamm H (eds): Herzkrankheiten. Springer Verlag Heidelberg New York 1982:pp 413–422Google Scholar
  10. 10).
    Sandler H, Dodge HT, Coble YD, Hay RE: The use of single plane angiocardiograms for the calculation of the left ventricular volume in man. Am Heart J 1968;75:Google Scholar
  11. 11).
    Rackley CE, Dodge HT, Coble YD, Hay RE: A method for determining left ventricular mass in man. Circulation 1964;29:666–671PubMedCrossRefGoogle Scholar
  12. 12).
    v. Herrath M, Holubarsch Ch, Hasenfuss G, Heiss HW, Just H: Repeat determination of left ventricular wall thickness from mass and volume during one cardiac cycle. Clinical Cardiology 1990;13:218–220CrossRefGoogle Scholar
  13. 13).
    Fifer MA, Grossmann W: Measurements of ventricular volumes, ejection fraction, mass, wall stress, and regional wall motion. In: Baim DS, Grossmann W (eds): Cardiac catheterization, angiography, and intervention. Williams and Williams 1996, Baltimore: pp 315–331Google Scholar
  14. 14).
    Minsky I: Elastic properties of myocardium. A quantitative approach with physiological and clinical application. In: Berne RM (ed), Handbook of Physiology. The Cardiovascular System. Washington, DC, American Physiological Society 1979:497–531Google Scholar
  15. 15).
    Holubarsch ChJF: Geometrical considerations in (reverse) remodeling. In: Surgical Remodeling in Heart Failure. Brett W, Todoro A, Pfisterer M, Zerkowski HR (eds). SteinkopffVerlag Darmstadt 2000:67–82CrossRefGoogle Scholar
  16. 16).
    Sarnoff SJ, Braunwald E, Welch GH, Case RB, Stainsby WN, Macruz R: Hemodynamic determinants of oxygen consumption of the heart with special reference to the tension-time index. Am J Physiol 1958;192:148–162PubMedGoogle Scholar
  17. 17).
    Hasenfuss G, Holubarsch Ch, Heiss W, Meinertz Th, Bonzel T, Wais U, Lehmann M, Just H: Myocardial energetics in patients with dilated cardiomyopathy. Influence of nitroprusside and enoximone. Circulation 1989;80:51–64PubMedCrossRefGoogle Scholar
  18. 18).
    Thierfelder L, Holubarsch Ch, Hasenfuss G, Heiss WH, Just H: The effect of the partial beta-1-adrenoceptor agonist xamoterol on hemodynamics and myocardial energetics in patients with dilated cardiomyopathy. J Cardiac Pharmacol 1991;17:593–599CrossRefGoogle Scholar
  19. 19).
    Holubarsch Ch, Hasenfuss G, Thierfelder L, Just H: Energetic consequences of substances currently used or recommended for long-term treatment of chronic heart failure. In: Smith JFM (ed): Pharmacology of cardiac and vascular remodeling. Steinkopff Verlag Darmstadt 1991:107–112Google Scholar
  20. 20).
    Rooke CA, Feigl EO: Work as correlate of canine left ventricular oxygen consumption, and the problem of catecholamine oxygen wasting. Circ Res 1982;50:273–286PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Christian J. F. Holubarsch
    • 1
  1. 1.Department of Cardiology & Angiology, Medizinische KlinikUniversity of FreiburgFreiburgGermany

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