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Related Experiment Video

Updated: May 9, 2026

Closed Chest Biventricular Pressure-Volume Loop Recordings with Admittance Catheters in a Porcine Model
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The decrease of cardiac chamber volumes and output during positive-pressure ventilation.

Kasper Kyhl1, Kiril Aleksov Ahtarovski, Kasper Iversen

  • 1The Cardiovascular Magnetic Resonance Imaging Group, Department of Cardiology, Rigshospitalet, Copenhagen, Denmark;

American Journal of Physiology. Heart and Circulatory Physiology
|July 30, 2013
PubMed
Summary
This summary is machine-generated.

Positive-pressure ventilation (PPV) reduces cardiac output and chamber volumes in healthy individuals, even at low levels. This decrease is primarily due to the Frank-Starling mechanism, impacting central circulation.

Keywords:
Frank-Starling relationshipcardiac physiologycardiovascular magnetic resonancecentral hemodynamicmechanical ventilationpositive-pressure ventilation

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Published on: February 20, 2017

Area of Science:

  • Cardiology
  • Respiratory Physiology
  • Medical Imaging

Background:

  • Positive-pressure ventilation (PPV) is crucial for acute cardiorespiratory failure.
  • Its effects on cardiac function and blood pressure are not fully understood.
  • Previous explanations focused on intracardiac pressure changes.

Purpose of the Study:

  • To evaluate the impact of PPV on central circulation using cardiac magnetic resonance imaging (CMR).
  • To test the hypothesis that PPV lowers cardiac output (CO) via the Frank-Starling mechanism.

Main Methods:

  • 18 healthy volunteers underwent CMR during varying PPV levels (0, 10, 20 cmH2O).
  • Cardiac chamber volumes and blood flow in the aorta and pulmonary artery were measured.
  • Measurements were taken using a respirator and face mask.

Main Results:

  • All cardiac chamber volumes decreased proportionally with increasing PPV.
  • Left ventricular stroke volume decreased by 27 ml/beat; CO decreased by 1.0 L/min.
  • Ventricular filling rates decreased, but maximal emptying rates remained unchanged.

Conclusions:

  • PPV significantly reduces cardiac filling and output in healthy subjects.
  • These effects occur even at low PPV levels and are explained by the Frank-Starling mechanism.
  • Consideration of these effects is vital when initiating mechanical ventilation.