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Left ventricular dysfunction following rewarming from experimental hypothermia

T Tveita1, K Ytrehus, E S Myhre

  • 1Department of Medical Physiology, University of Tromso, N-9037 Tromso, Norway.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|December 8, 1998
PubMed
Summary

Hypothermia impairs dog heart function, causing both systolic and diastolic disturbances. After rewarming, diastolic function recovers, but systolic dysfunction persists, indicating long-lasting effects on heart muscle contraction.

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Area of Science:

  • Cardiology
  • Physiology

Background:

  • Hypothermia is used therapeutically but can cause cardiac dysfunction.
  • Understanding the specific nature of post-hypothermia cardiac dysfunction is crucial for patient management.

Purpose of the Study:

  • To determine if persistent left ventricular (LV) dysfunction after rewarming from hypothermia is primarily systolic, diastolic, or combined.
  • To investigate the underlying mechanisms of hypothermia-induced cardiac dysfunction.

Main Methods:

  • Mongrel dogs underwent gradual cooling to 25°C and rewarming to 37°C.
  • Systolic function was assessed using dP/dtmax, segment shortening, stroke volume, and preload recruitable stroke work.
  • Diastolic function was evaluated using isovolumic relaxation time constant (tau) and LV wall stiffness (Kp).

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Main Results:

  • Hypothermia significantly decreased all measured systolic and diastolic LV functional variables.
  • After rewarming, diastolic function (Kp and tau) returned to baseline levels.
  • Persistent depression in systolic function (dP/dtmax, SS%, SV, PRSW) was observed post-rewarming.

Conclusions:

  • Hypothermia induces both systolic and diastolic left ventricular dysfunction.
  • Post-hypothermia cardiac dysfunction is predominantly a systolic perturbation due to lasting effects on excitation-contraction coupling and actin-myosin interactions.
  • Diastolic function recovers more readily after rewarming compared to systolic function.