These studies will examine the effect of surgical correction of acquired and congenital heart disease on the systolic and diastolic properties of the left and right ventricles in human adults, children, and infants. State of the art measuring devices and algorithms will be employed for intraoperative measurements and long-term followup. Improved pump function during corrective surgery will be correlated with changes in myocardial properties, since impaired contractility and compliance can be hidden by improved hemodynamics. For specific operations in which the pathophysiology of surgical correction is not well understood, mechanisms that promote a successful long term result will be defined. Outpatient studies will examine chronic changes in ventricular size and function, which will be related to intraoperative events. Laboratory studies will develop advanced methods for intraoperative study and reduce the cost of such studies, making the technology widely available. Intraoperative measurements will include pressure by micromanometer, flow by electromagnetic or ultrasonic flowmeter, and dimensions by sonomicrometry, two-dimensional echocardiography, and ventricular conductance. End-diastolic volume will be correlated with end-diastolic pressure to measure compliance, and with pressure-volume stroke work to measure contractile function (preload recruitable stroke work). Contractility will also be measured from pressure-volume loops (end-systolic pressure-volume relation). End-diastolic pressure-ventricular performance relations will also be measured, since these directly influences patient symptoms. These goals will be accomplished by a dedicated faculty with the right combination of clinical experience and laboratory background to conduct such studies effectively and safely. Results will improve care of patients undergoing cardiac surgery, will clarify deficiencies of current management, will expand understanding of the pathophysiology of heart surgery, and will make low cost methods for the study of systolic and diastolic properties generally available to cardiac surgeons and laboratory scientists.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL048109-11
Application #
6603769
Study Section
Surgery and Bioengineering Study Section (SB)
Program Officer
Pearson, Gail D
Project Start
1992-05-01
Project End
2006-06-30
Budget Start
2003-07-01
Budget End
2004-06-30
Support Year
11
Fiscal Year
2003
Total Cost
$290,843
Indirect Cost
Name
Columbia University (N.Y.)
Department
Surgery
Type
Schools of Medicine
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Gray, Robert G; Cabreriza, Santos E; Quinn, T Alexander et al. (2010) Feasibility of in vivo pressure measurement using a pressure-tip catheter via transventricular puncture. ASAIO J 56:194-9
Spotnitz, Henry M (2010) Ventricular function in surgery for congenital heart disease. World J Surg 34:669-74
Richmond, Marc E; Cabreriza, Santos E; Van Batavia, Jason P et al. (2008) Direction of preoperative ventricular shunting affects ventricular mechanics after Tetralogy of Fallot repair. Circulation 118:2338-44
Berberian, George; Quinn, T Alexander; Cabreriza, Santos E et al. (2007) Left ventricular pacing site and timing optimization during biventricular pacing using a multielectrode patch in pigs. J Thorac Cardiovasc Surg 134:574-8
Berberian, George; Quinn, T Alexander; Cabreriza, Santos E et al. (2006) Load dependence of cardiac output in biventricular pacing: left ventricular volume overload in pigs. J Thorac Cardiovasc Surg 131:666-70
Berberian, George; Cabreriza, Santos E; Quinn, Thomas Alexander et al. (2006) Left ventricular pacing site-timing optimization during biventricular pacing using a multi-electrode patch. Ann Thorac Surg 82:2292-4
Garofalo, Cara A; Cabreriza, Santos E; Quinn, T Alexander et al. (2006) Ventricular diastolic stiffness predicts perioperative morbidity and duration of pleural effusions after the Fontan operation. Circulation 114:I56-61
Kenny, Jon-Emile S; Berberian, George; Rabkin, David G et al. (2006) Ethanol induction of complete heart block in swine. J Surg Res 132:142-6
Quinn, T Alexander; Berberian, George; Cabreriza, Santos E et al. (2006) Effects of sequential biventricular pacing during acute right ventricular pressure overload. Am J Physiol Heart Circ Physiol 291:H2380-7
Berberian, George; Quinn, T Alexander; Vigilance, Deon W et al. (2005) Validation study of PulseCO system for continuous cardiac output measurement. ASAIO J 51:37-40

Showing the most recent 10 out of 41 publications