Echocardiography Methods for assessing systolic function (contractile function) Several echocardiographic measurements are available to assess left ventricular systolic function. These methods elucidate slightly different aspects…

…wall thickness (myocardial thickness). The left ventricle must generate sufficient contractile force to overcome the pressure in the aorta. The greater the pressure in the…

…interventions are time sensitive, and to maximize the likelihood of restoring spontaneous circulation, interventions should be adapted to the current phase. However, current guidelines do…

…Viable, stunned, and hibernating myocardium Viable dysfunctional myocardium is myocardial tissue whose contractile function improves after coronary revascularization. This functional definition encompasses several physiological states…

…including: Global and regional LV systolic function LV contractile reserve Valve function and stress related haemodynamic changes Diastolic function Pulmonary hypertension Coronary flow velocity reserve…

…that ultimately intracellular calcium concentration increases. This makes more calcium available to the contractile proteins which therefore produce stronger contractions. Lowering of the heart rate…

…1. Ventricular rhythm. One exception to the rule above should be noted. If an ectopic focus arises in or near the bundle of His, the…

…ischaemia should instead be classified as acute myocardial injury. Mechanisms of troponin release Troponin I and troponin T are components of the myocardial contractile apparatus…

…to consider loading conditions when evaluating the measured ejection fraction. Ideally, ejection fraction should be assessed during normal, with regards to the patient, loading conditions…

Echocardiography Echocardiographic assessment of regional contractile function Systolic ventricular function is one of the strongest predictors of total and cardiovascular mortality. Previous chapters have discussed…

Echocardiography Structure and contractile function of myocardial fibers The left ventricular wall can be subdivided into several layers. These layers are similar to those seen…

…Vasopressors induce vasoconstriction and increase mean arterial pressure (MAP). Inotropes increase cardiac contractile force (contractility). Several endogenous and synthetic agents exist and are frequently combined…

…Vasopressors induce vasoconstriction and increase mean arterial pressure (MAP). Inotropes increase cardiac contractile force (contractility). Several endogenous and synthetic agents exist and are frequently combined…

…wave. Because of the long duration of the plateau phase most contractile cells are in this phase at the same time (more or less). Moreover…

…discussed, all cardiac cells—both conduction and contractile cells—must undergo rapid repolarization to ensure they are excitable when the next action potential occurs. If…

…capable of transmitting the action potential, albeit at a much lower speed than the conduction cells. The terms contractile myocardium , myocardium, or simply myocardial cell…

…function. This is due to the following reasons: Left ventricular geometry must be normal. There must not be regional differences in contractile function. Otherwise, the…

…cellular functions, such as contraction and relaxation. Increasing cardiac workload by increasing heart rate and contractility (i.e contractile force), results in increased metabolism. Cardiac…

…ventricular contraction. In contrast, contractile cells–and Purkinje fibers in particular–are rich in gap junctions, enabling rapid impulse conduction through the ventricles. After passing…

…zone and contributes to ventricular failure. Mechanisms of Shock The central consequence of extensive infarction is loss of contractile myocardium, with reduced cardiac output and…

…endocardium, where they deliver the action potential to contractile cells. The subsequent spread of the action potential occur from one contractile cell to another, starting…

…chronic aortic regurgitation gradually leads to impaired contractile function and the development of myocardial fibrosis. Contractile dysfunction further aggravates the regurgitation (the regurgitation volume increases…

…of the ventricular myocardium. This is presumably due to a mismatch between the expansion of contractile cells as compared with conduction cells. Therefore it is…

…Figure 1. The action potential in the sinoatrial node and in contractile myocardial cells. Phase 4 of the action potential in the sinoatrial node is…

…particularly the ventricular myocardium. Sympathetic stimulation has a positive inotropic effect (i.e increases contractile force in the myocardium), positive chronotropic effect (i.e increases…

…cells form bundles of fibers that spread the action potential rapidly and sequentially to the contractile myocardium. When the contractile myocardium receives the action potential…

…and Purkinje fibers. The conduction system allows for rapid spread of the depolarization to the contractile cells. Figure 3 illustrates the components of the conduction…

…other cytokines. Within the intima, SMCs undergo a phenotypic switch from a contractile to a synthetic state, producing abundant extracellular matrix (ECM) components, primarily interstitial…

…ventricular function — e.g ejection fraction (EF), fractional sorting (FS), etc — do not elucidate regional variations in contractile function, or the effectiveness of longitudinal, radial…

…ejection fraction (LVEF). This is accompanied by myocardial remodeling. The remodeling is accompanied by diminishing myocardial contractile function. Central venous pressure, pulmonary capillary wedge pressure…