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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In eleven young healthy subjects, vital capacity was reduced by 30% by thoracic or abdominal strapping and the effects of this on maximal work capacity, ventilation and circulation were examined. During exercise as well as at rest, tidal volume and stroke volume were reduced and respiratory frequency and heart rate were increased with both types of strapping. Cardiac output appeared to be decreased. Thoracic strapping was slightly but significantly more impeding than abdominal strapping: residual volume, tidal volume and maximal work capacity were smaller. In both instances, the decrease in maximal performance was apparently due to ventilatory as well as circulatory limitation.
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PMID:Effects of thoracic or abdominal strapping on exercise performance. 672 62

Impedance cardiography (IC) is a reliable noninvasive technique for monitoring stroke volume (SV) and cardiac output. Transthoracic impedance (Zo) is one variable in the equation used for the calculation of SV. Thoracic impedance reflects the resistivity offered by tissues and air and the length and cross-sectional area of the thoracic volume. The purpose of this study was to evaluate possible differences in Zo between men and women. Measurements (Mean +/- S.D.) of Zo in 29 men (age 25.6 +/- 4.6 yr) and 35 women (24.2 +/- 6.0 yr) in the seated posture revealed Zo values were significantly (p less than 0.05) greater for the women (31.5 +/- 3.3 ohm) than the men (23.5 +/- 1.84 ohm). The observed differences in Zo cannot be attributed to thoracic length; distances between the monitoring electrodes were similar for the men (25.1 cm) and the women (25.7 cm). We hypothesize that the greater Zo observed for women is due to a smaller thoracic cross-sectional area and greater resistivity resulting primarily from relatively more fat tissue, smaller heart size, and lesser central blood volume as compared with men.
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PMID:Transthoracic impedance: differences between men and women with implications for impedance cardiography. 715 39

Blood resistivity (rho) values used in the Kubicek formula for stroke volume (SV) calculation by impedance cardiography are bench derived and do not take into account complex blood velocity movements and dynamic hematocrit changes in systole. In this study, the relevance of rho has been questioned. Thoracic resistivity (rho tau) has been calculated in dogs from the rearranged Kubicek formula: rho tau = (SV . ZO2)/(L2 dZ/dtmax.T), where SV was measured by the electromagnetic flowmeter (EM). Hematocrit (Hct) in the dog was varied by hemorrhage and infusion. In contrast to the direct and exponential bench rho-Hct relationship, rho tau varies inversely with Hct, but by no more than +6.3 omega . cm (at Hct 26%) and -11.8 omega . cm (at Hct 66%) about a mean rho tau of 135 +/- 1.0 omega . cm (at Hct 40%). Impedance SV calculated using rho tau over a wide range of SV bears a linear relationship to EM values with a 95% prediction limit for a single SV estimate of +/- 0.84 about a mean value of 26.9 ml. The findings suggest that rho tau is virtually constant during a variety of physiological disturbances.
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PMID:Thoracic resistivity for stroke volume calculation in impedance cardiography. 720 86

Studies have shown that angiotensin-converting enzyme (ACE) inhibitor treatment in young genetically hypertensive rats prevents the full expression of blood pressure and vascular abnormalities in the adult. This model provides unique conditions with which to study the pathogenesis of altered Ca++ regulation. Normotensive (WKY) rats and stroke-prone spontaneously hypertensive rats (SHRSP) received at 6 to 10 weeks of age either ACE inhibitor (ramipril), hydralazine/hydrochlorothiazide or no treatment. At 17 weeks of age, rats were anesthetized, and vascular tissue was excised. Thoracic aorta challenged with 20 mM caffeine in Ca(++)-free buffer produced a phasic contractile response. The magnitude of this phasic response was used as a measure of Ca++ released from intracellular stores; a direct correlation between this phasic response and systolic blood pressure was observed. A concentration-response curve to Bay K8644 was performed on carotid arteries; a direct correlation of force development to Bay K8644 and systolic blood pressure was observed. All WKY groups showed lower blood pressure and force development in response to Bay K8644 than did SHRSP. Treatment with ramipril reduced blood pressure and force development in response to Bay K8644 in adult SHRSP, although not to levels of WKY rats, whereas WKY rats were unaffected by treatment. These data support the hypothesis that contractile responses to Bay K8644 in carotid arteries and caffeine in aorta parallel changes in systolic blood pressure. We conclude that alteration of Ca++ regulation in hypertension is directly related to elevated blood pressure and mediated by an angiotensin II-sensitive mechanism during development.
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PMID:Angiotensin-converting enzyme inhibition during development alters calcium regulation in adult hypertensive rats. 750 33

This paper reviews the cardiovascular responses of six healthy male subjects to 6 hours in a 5 degrees head-down bed rest model of weightlessness, and compares these responses to those obtained when subjects were positioned in head-up tilts of 10 degrees, 20 degrees, and 42 degrees, simulating 1/6, 1/3, and 2/3 G, respectively. Thoracic fluid index, cardiac output, stroke volume, and peak flow were measured using impedance cardiography. Cardiac dimensions and volumes were determined from two-dimensional guided M-mode echocardiograms in the left lateral decubitus position at 0, 2, 4, and 6 hours. Cardiovascular response to a stand test were compared before and after bed rest. The impedance values were related to tilt angle for the first 2 hours of tilt; however, after 3 hours, at all four angles, values began to converge, indicating that cardiovascular homeostatic mechanisms seek a common adapted state, regardless of effective gravity level (tilt angle) up to 2/3 G. Echocardiography revealed that left ventricular end-diastolic and end-systolic volume, stroke volume, ejection fraction, heart rate, and cardiac output had returned to control values by hour 6 for all tilt angles. The lack of a significant immediate change in left ventricular end-diastolic volume, despite decrements in stroke volume (P < .05) and heart rate (not significant), indicates that multiple factors may play a role in the adaptation to simulated hypogravity. The echocardiography data indicated that no angle of tilt, whether head-down or head-up for 4 to 6 hours, mimicked exactly the changes in cardiovascular function recorded after 4 to 6 hours of space flight. Changes in left ventricular end-diastolic volume during space flight and tilt may be similar, but follow a different time course. Nevertheless, head-down tilt at 5 degrees for 6 hours mimics some (stroke volume, systolic and diastolic blood pressure, mean arterial blood pressure, and total resistance), but not all, of the changes occurring in an equivalent time of space flight. The magnitude of the change in the mean heart rate response to standing was greater after six hours of tilt at -5 degrees or 10 degrees. Thus, results from the stand test after 6 hours of bed rest at -5 degrees and 10 degrees, but not at 20 degrees or 42 degrees, are similar to those obtained after space flight.
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PMID:Comparison of cardiovascular function during the early hours of bed rest and space flight. 808 61

Thoracic epidural analgesia combined with chronic beta-adrenergic blocker medication may cause cardiac depression. We investigated the cardiovascular and myocardial metabolic effects of a T1-T12 epidural block in 18 patients (age < 65 yr, ejection fraction > 0.5), receiving chronic beta-adrenergic blocker medication and scheduled for aortocoronary bypass surgery. After randomization into a light or deeper general anesthetic group, the cardiovascular and myocardial metabolic effects of a subsequent general anesthesia induction were investigated. Thoracic epidural analgesia induced a moderate decrease in mean arterial pressure, coronary perfusion pressure, free fatty acids, and myocardial consumption of free fatty acids. General anesthesia with thiopental (2-4 mg/kg) and a low fentanyl dose (5 micrograms/kg) increased heart rate, coronary perfusion pressure, and coronary vascular resistance, whereas mean pulmonary arterial pressure and pulmonary capillary wedge pressure decreased. After thiopental (2-4 mg/kg) and a high fentanyl dose (30 micrograms/kg), mean arterial pressure and left ventricular stroke work index decreased. We conclude that a T1-T12 epidural block in well sedated, beta-adrenergic blocked patients does not induce clinically significant cardiovascular effects. Induction of general anesthesia was well tolerated, but the light general anesthetic could not prevent an increase in heart rate and coronary vascular resistance, whereas the deeper anesthetic induced slight myocardial depression. No effect on the atrioventricular conduction, as measured by the PQ-time, was noted.
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PMID:The influence of thoracic epidural analgesia alone and in combination with general anesthesia on cardiovascular function and myocardial metabolism in patients receiving beta-adrenergic blockers. 810 48

Deendothelialized rings of rabbit aorta relax after exposure to UV light because of release of a relaxing factor that is similar if not identical to nitric oxide. We tested the hypothesis that production of the photo-induced relaxing factor is impaired in a rat model of genetic hypertension. Thoracic aortas were removed from adult Wistar-Kyoto rats and stroke-prone spontaneously hypertensive rats. The vessels were cut into rings, denuded of endothelium, and placed in a muscle bath for isometric force measurement. Rings were contracted with phenylephrine, and relaxation was measured after exposure to UV light. Aortic rings from stroke-prone spontaneously hypertensive rats relaxed to a greater extent after exposure to UV light than did rings from Wistar-Kyoto rats. An inhibitor of nitric oxide synthase (N omega-nitro-L-arginine) greatly potentiated the relaxation responses to light in both strains, and these enhanced relaxations were attenuated by tetraethylammonium chloride, potassium chloride, ouabain, or inhibitors of guanylate cyclase. These results suggest that UV irradiation induces relaxation in aortic smooth muscle that is greater in hypertensive than normotensive rats and is greatly enhanced after addition of inhibitors of nitric oxide production. Thus, the unidentified photo-induced relaxing factor is not solely nitric oxide but may also represent either a hyperpolarizing factor, because depolarization blocks the responses entirely, or possibly smooth muscle guanylate cyclase that might itself be photoactivable.
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PMID:A photoactivable source of relaxing factor in genetic hypertension. 820 24

During activity, the increase in body temperature triggers the pacemaker to adjust by increasing the rate. To assess the hemodynamic advantages twelve patients were studied. Heart function was measured by a noninvasive bioimpedance method. Heart functions were measured first at rest and then at the end of the exercise. Exercise was done in temperature mode and then later at a fixed heart rate. Cardiac output increased by 64% in temp mode compared to the fixed heart rate during the exercise. Stroke Volume increased by 38%. The Thoracic Fluid Index, Ventricular Ejection Time, Ejection Velocity Index and Ejection Fraction were unchanged. Hemodynamics are better in temp sensing rate responsive pacing during activity compared to fixed rate pacing. Clinically, the patients are doing well.
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PMID:Hemodynamic advantages of temperature sensing rate adaptive pacemaker. 827 55

Haemodynamic monitoring of intensive care unit (ICU) patients can be carried out by thermodilution system. This method is invasive, does not give a continuous monitoring and complications can occur. Thoracic electrical bioimpedance (TB), a non invasive, fast, easily repeatable method, is able to measure some important haemodynamic parameters: end diastolic volume (EDV), stroke volume, cardiac output (CO), ejection fraction (EF), some contractility indexes, systemic vascular resistances (SVR) and cardiac work. The aim of the present study is to compare CO and SVR obtained by thermodilution with the same indexes obtained by TB. Therefore, 20 ICU patients (12 males and 8 females, mean age 54 +/- 11 years) were studied. Out of them, 16 had been submitted to cardiac surgery in the previous 7 days and 4 were waiting for cardiac surgery. The patients were divided in 2 groups: Group A (N 4) included patients with valvular malfunction and/or cardiac arrhythmias and Group B (N 16) included patients with normal valvular function and sinus rhythm. CO obtained by TB was well related with the one obtained by invasive (INV; r = 0.878; p < 0.001). The mean value of difference of the 2 methods was 12.29 +/- 11.83 for the whole group of 20 patients but it was 26.07 +/- 14.16 in the Group A and 8.84 +/- 8.09 in the Group B confirming the less reliability of the method in patients with abnormal valvular function or in the presence of cardiac arrhythmias. As a consequence, SVR obtained by TB and INV resulted well related (r = 0.752; p < 0.001). The mean value of differences was 11.14 +/- 9.01 in the group of 20 patients and particularly 19.55 +/- 10.87 in the Group A and 9.04 +/- 7.07 in the Group B. In a subgroup of 9 patients, CO was measured at successive times (0, 30, 60, 90 min) by both TB and INV; when comparing the 2 CO values a significant correlation was observed. In conclusion, TB represents a valid method in haemodynamic monitoring of the ICU patients.
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PMID:[The usefulness of bioimpedance in patient monitoring in an intensive-therapy heart-surgery unit: a comparison with thermodilution]. 828 87

Thoracic procedures once requiring open thoracotomy are now being performed with video-assisted thoracoscopy. To visualize adequately the intrathoracic structures, creation of an artificial pneumothorax by carbon dioxide insufflation under positive pressures has been advocated. We hypothesized that positive-pressure insufflation during thorascopy would cause significant hemodynamic compromise. Eight healthy female pigs underwent general endotracheal anesthesia and placement of monitoring lines. After placement of a thorascope, baseline hemodynamic measurements were obtained at 0 mm Hg (atmospheric pressure). Measurements were taken randomly at 5, 10, and 15 mm Hg using carbon dioxide insufflation after stabilization at each pressure. Data were analyzed using Page's test for noparametric variables. Insufflation pressures of 5 mm Hg or greater resulted in significant decreases in cardiac index, mean arterial pressure, stroke volume, and left ventricular stroke work index, whereas central venous pressure increased (p < 0.001). Changes in heart rate were not significant. We do not recommend routine positive-pressure insufflation during thorascopy because of the significant hemodynamic compromise in our experimental model.
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PMID:Effects of insufflation on hemodynamics during thoracoscopy. 851 84


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