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The Journal of Thoracic and Cardiovascular Surgery, Vol 97, 565-574, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
H Ando, E Nakano, Y Ueno and K Tokunaga
In 12 dogs being supported by cardiopulmonary bypass, the relationship
among myocardial oxygen consumption and four energy-consuming factors
(basal metabolism, heart rate, tension development, and external work) was
studied. Tension (internal work) in the left ventricular wall was evaluated
by myocardial tissue pressure with a Mikro-Tip pressure transducer. In an
empty beating heart with constant perfusion pressure, both systolic tissue
pressure and developed tissue pressure represented the same characteristics
as developed tension measured by other methods. As the heart rate was
increased, the systolic tissue pressure and developed tissue pressure
continued to increase stepwise (Bowditch effect) up to some stimulation
rate, at which, however, a decrease began despite a further increase in
heart rate (Woodworth effect). Significant regression was established
between myocardial oxygen consumption and heart rate, tension (developed
tissue pressure x heart rate), and external work (minute work): myocardial
oxygen consumption = (9.05 x 10(-3) heart rate) + (1.95 x 10(-4) developed
tissue pressure) x heart rate + (1.63 x 10(-3) minute work) + 1.42 (r =
0.7999), where activation energy = 9.05 x 10(-3) ml/100 gm per beat,
tension-related energy = 1.95 x 10(-4) ml/100 gm per unit of internal work,
energy for work = 1.63 ml/100 gm per unit of external work, and basal
metabolism = 1.42 ml/min/100 gm. We concluded that myocardial tissue
pressure is a good substitute for tension and that multiple regression with
heart rate, tension, and external work (as by modified Fenn's equation)
seems indispensable to predict myocardial oxygen tension in the whole
heart.
ARTICLES
New technique for analysis of cardiac energetics using a modified Fenn equation
Division of Cardiovascular Surgery, Kyushu University, Faculty of Medicine, Fukuoka, Japan.
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