Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Концепция регуляции сердечно-сосудистой системы - от управления функциями к согласованию возможностей. Часть 5. Роль регуляции

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Link: Clinical Physiology of Blood Circulaiton. 2013; (): -

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Abstract

Objective. To present the role of regulation in genesis of dilated cardiomyopathy (DCM).
Material and methods. 49 patients with DCM were examined. Computer monitoring, echocardiography, statistical and personal analyses based on math models, identified according to clinical control were used.
Results. In part 4 of the article it is presented that patients with DCM have significant differences in evaluation of functions and properties at rest in horizontal position compared with healthy group. Simulation and analysis on individualized models allowed separating and differentiating processes that determine the function, pathology and regulation in statistically combined groups and for each patient individually. Based on correlation ratio, regulation coefficients and functional relationship of these processes, we made a conclusion that cardiac index (CI) rise (on 26% compared with mean value) in group I is determined by regulation, directed on rise pumping capacity of the right ventricle index (RVI) (+66%) under decreased pumping capacity of the left ventricle index (LVI) (-28%) and index of total peripheral resistance (ITPR) (-24%) and also with significant shifts of indexes of total pulmonary resistance and compliance of pulmonary arterial vascular reservoir. In group II, decrease of CI on 31% is determined by pathologic and regulatory processes that have changed RVI on -37%, LVI in 2.6 times, ITPR on 23% and etc.
Conclusion. The cause of DCM is regulation disturbance. Regulation disturbance allowed us to explain evident and significant difference of mean variables of patient groups with CI, which is above the average (3.1 l/min/m2) and below the average (1.9 l/min/m2). Individual status modeling of patients with high and low CI confirmed this conclusion and let us to perform simulation synthesis of individual therapy that accepts personal peculiarities of a patient.

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