Dynamics of cardiac minute volume in the diagnosis of heart failure in acquired heart defects and ischemic heart disease in the postoperative period
Amosov, N.M.; Knyshov, G.V.; Mintser, O.P.; Ugarov, B.N.; Kononenko, I.N.
Kardiologiia 22(10): 21-23
1982
ISSN/ISBN: 0022-9040 PMID: 7176312 Document Number: 192989
Continuous minute heart volume [MHV] monitoring was elaborated using tetrapolar rheography, and heart function criteria were determined for the early postoperative period [EPP] in patients with heart defects and ischemic heart disease [IHD]. Patients (116) were examined after heart valve implant and surgical treatment of IHD. The MHV depended on 5 factors: preloading and postloading, heart rate, myocardial state [MCS] and the inotropic effect of the hormonal system on the heart. The degree of MHV variation was determined by the functional MCS. Analysis of central hemodynamic parameters [HP] revealed that MHV was the most stable parameter although some deviations were observed. Three types of central HP interrelationships were isolated: a constant type of circulatory regulation [CR] provided by MHV constancy; a concordant type of CR, when MHV changes correlated with basic HP; and a discordant type which was determined externally and was unrelated to central HP. Transitions from one type into another were also observed. Comparison of the frequency of leading complications and lethal outcomes revealed that they usually occurred with the discordant CR. Artificial regulation during the constant CR did not lead to desired shifts and was probably not required. With concordant CR, natural regulation was at its limit and therefore MHV correction was required. Although discordant CR was the most unfavorable, circulatory stabilization and transition into the concordant CR was possible with proper treatment. The effect of drugs was of short (1-1.5 h) duration. An unstable MHV usually indicated an unfavorable prognosis.