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Influences of Coronary Venous Pressures on Left-Ventricular Function

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Cardiac-Vascular Remodeling and Functional Interaction

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Summary

In this chapter, we present experimental evidence for the functional influences of the coronary venous system on cardiac performance. The drainage pattern of the canine venous system is described, and casts of the venous circulation establish that venous vascular volume is about twice that of the arterial vascular volume. Experimental evidence is presented demonstrating that coronary arterial flow, both after vasodilation and with intact vasoactivity, is reduced with elevated right heart pressures. Coronary collateral flow (in the presence of arterial occlusion) is also reduced with elevated right heart pressures. Experiments show that increasing left-ventricular volume in a vasodilated heart reduces coronary flow proportionally while there is practically no influence on flow in the vasoactive heart. Pressure interactions between the right heart and left-ventricular pressure are more pronounced in the vasodilated heart compared to the vasoactive heart and more prominent in a stiffer versus a compliant heart. Evidence is presented that elevated right heart pressures reduce the compliance of the left ventricle, which is even more pronounced in the vasodilated state. Finally, evidence for a “venous Gregg effect” is presented. Here we observed that an increase in right heart pressure resulted in an increase in the maximally generated pressure within the left ventricle, increased the maximum rate of change in left-ventricular pressure (index of contractility), and increased myocardial oxygen consumption. The studies suggest a prominent role for the venous circulation on cardiac function, which takes on greater importance in the failing heart when right heart pressures can be as high as 30 mmHg

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Authors and Affiliations

  1. Department of Physiology, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, 76107-2699, USA

    Konrad W. Scheel & Kristin Bryant

  2. Ramez Street, P.O. Box 264, Kadima, 60920, Israel

    Dan Manor

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  1. Konrad W. Scheel
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  3. Kristin Bryant
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Editors and Affiliations

  1. First Department of Internal Medicine, Fukushima Medical College, Hikariga-oka 1, 960-12, Fukushima, Japan

    Yukio Maruyama M.D., Ph.D. (Professor and Chairman) (Professor and Chairman)

  2. First Department of Medicine, Osaka University School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565, Japan

    Masatsugu Hori M.D., Ph.D. (Chief) (Chief)

  3. College of Veterinary Medicine, Auburn University, 106 Greene Hall, 36849-5517, Auburn, AL, USA

    Joseph S. Janicki Ph.D. (Professor, Associate Dean of Research and Graduate Studies) (Professor, Associate Dean of Research and Graduate Studies)

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Scheel, K.W., Manor, D., Bryant, K. (1997). Influences of Coronary Venous Pressures on Left-Ventricular Function. In: Maruyama, Y., Hori, M., Janicki, J.S. (eds) Cardiac-Vascular Remodeling and Functional Interaction. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67041-4_26

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  • DOI: https://doi.org/10.1007/978-4-431-67041-4_26

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