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PubMed1993

[Blunt cardiac trauma resulting in ventricular septal perforation and mitral regurgitation due to papillary muscle rupture--a case report].

A 13-year-old girl was hit by a car and referred to our hospital because of progressive chest discomfort, cough, ECG abnormalities and sustained hypotension. 2-D/Doppler echocardiography recorded on admission demonstrated ventricular septal perforation with L-R shunt and mitral regurgitation due to rupture of the posterior papillary muscle and its adjacent myocardium. Patch closure of the ventricular septal perforation and fixation of the papillary muscle were performed. In five years after surgery, the patient is doing well with no echocardiographic evidence of mitral regurgitation.

Adolescent↗

PubMed1981

Positive inotropic and relaxant effects of papaverine on cat papillary muscle.

The effects of papaverine and isoproterenol on the isometric twitch and high KCl-induced contractures were compared in papillary muscles from reserpinized cats. Papaverine (10(-5) M) significantly increased developed tension (T), maximal rate of rise of tension (+dT/dt max) and maximal velocity of relaxation (--dT/dt max) in 52.3 +/- 6.1, 74.1 +/- 6.7 and 82.1 +/- 12.1% respectively with respect to control values. Time to peak tension (TTP) and contracture tension decreased in 9.1 +/- 2.0% and 50.9 +/- 5.6% respectively with respect to controls (P less than 0.05). Isoproterenol in a dose (8 X 10(-10) M), that produced an increase in +dT/dt max non significantly different to the one elicited by papaverine (65.6 +/- 9.0%), increased (in % with respect to control values), T in 55.3 +/- 7.3, --dT/mx in 73.8 +/- 13.1 and decreased TTP in 6.6 +/- 1.1 and contracture tension in 40.7 +/- 6.3 (P less than 0.05). The effects of isoproterenol on all the parameters studied were not statistically different from the ones of papaverine. It is concluded that in cat papillary muscles, papaverine has a positive inotropic action and an isoproterenol-like relaxant effect.

Animals↗

PubMed1993

Suspension of the papillary muscles during valve replacement for mitral stenosis.

Of 94 patients who underwent intravalvular mitral valve replacement with CarboMedics bileaflet mechanical prosthesis, 10 presented with heavily calcified stenotic valves. After total excision of the mitral valve in these patients, both papillary muscles were reconnected to the annulus with Goretex sutures. Repeat cardiac catheterization was completed in six of these 10 patients two to 24 months after surgery. Global and segmental left ventricular function was estimated using the MEDIS program (Thorax Centrum, Rotterdam) for analysis of left ventricular function. In five of the six patients re-examined, the ejection fraction was improved, the global ejection fraction increasing from 54% +/- 6% to 63% +/- 10%. We conclude, even though the number of followed patients is extremely small, that mitral valve replacement with suspension of the papillary muscles is surgically feasible and has beneficial effects on the contractility of the left ventricle in patients with mitral stenosis.

Follow-Up Studies↗

PubMed1987

Analysis of papillary muscle images on planar thallium-201 myocardial scintigrams in various heart diseases.

201Tl myocardial imaging can, noninvasively, visualize the various cardiac structures; such as the left ventricle, right ventricle and, occasionally, the atrium. We have noted that certain patients exhibit a prominent appearance of the papillary muscle on a scintigram. Thus, we analyzed 201Tl myocardial scintigrams for evidence of activity which corresponded to the anterolateral (A-PM) and posteromedial (P-PM) papillary muscles. Twenty normal subjects, 81 patients with ischemic heart disease (IHD), 11 with hypertrophic cardiomyopathy (HCM) and 13 with dilated cardiomyopathy (DCM) were examined. Patients with DCM had rest imaging only, while the remaining ones performed exercise studies. The prevalence of a positive A-PM image was not high (9%-23%) and there was no significant difference among groups. The P-PM was seen in only 15% of the normal group and in 18% of the HCM group, while the prevalence was high in the IHD (34.6%) and DCM (53.8%) groups. In the IHD, the positive images of the P-PM were largely from the sub-group with single vessel left anterior descending (LAD) coronary artery disease (78.9%). However, even in the presence of a defect in the left ventricular wall supplied by the LAD coronary artery, the patients with multi-vessel coronary artery disease did not tend to disclose the P-PM on the scintigram (30.8%). Thus, we conclude that positive P-PM imaging on a planar 201Tl myocardial scintigram is frequently observed under some cardiac states and seems to be related to reduced wall motion, sound blood supply to the P-PM and the existence of a defect in the anterior left ventricular wall overlapping the P-PM.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1999

Lipocortin-1 preserves myocardial responsiveness to beta-adrenergic stimulation in rat papillary muscle.

1. During septic shock, myocardial contractile dysfunction is accompanied by the release of cytokines and enhanced production of nitric oxide, and the contractile dysfunction is prevented by glucocorticoids. 2. Myocardial dysfunction was induced in vitro by incubation of rat papillary muscle for 15 h with endotoxin (lipopolysaccharide, LPS) and interferon-gamma (IFN-gamma). 3. Both baseline contractile function and inotropic responsiveness to isoprenaline were markedly reduced by the combination of LPS plus IFN-gamma. 4. Lipocortin-1 (LC-1) is induced by glucocorticoids, and LC-1(2-26), its N-terminal fragment, protected the papillary muscle inotropic responsiveness to isoprenaline, but did not affect the decline in baseline contractile function induced by LPS plus IFN-gamma. 5. The mechanisms of this protective action need to be explored further, but LC-1 may prove to be a novel cardioprotective agent for the management of septic shock.

Adrenergic beta-Agonists↗

PubMed1968

Temporal relation between long-lasting aftercontractions and action potentials in cat papillary muscles.

Sotalol, an adrenergic-blocking and antiarrhythmic agent, increases markedly and simultaneously the duration of both action potentials and contractions in papillary muscles. The active tension is manifested as a main twitch contraction followed by a maintained low level of residual tension (aftercontraction) which persists until the terminal phase of rapid repolarization. The Strength of the aftercontraction is augmented when the extracellular concentration of calcium is increased.

Action Potentials↗

PubMed1997

[A comparative analysis of the intracellular potassium content for the cardiomyocyte in papillary muscle tissue and in a primary heart culture].

This work was aimed to examine potassium contents in heart myocytes. The intracellular concentration of this element was measured with electron probe microanalysis (EPMA). The cardiomyocyte was studied in samples of the papillary muscle tissue and in heart primary culture. The low temperature fixation was applied to the sample preparation. As a result, cells of the primary heart culture were shown to be separated into three kinds of myocytes, defined by their different shape, size and cellular potassium content. The rod cardial cell, to be used for electrophysiological assays, has potassium and sodium concentrations close to those of the papillary muscle. The difference in potassium concentrations is to be explained presumably by the injury of cell membrane during the primary culture preparation. Healing over the membrane is likely to parallel with the membrane damage resulting from a continuous destruction of the cellular assembly in primary culture.

Animals↗

PubMedDate not supplied

Intermittent obstruction of the Omnicarbon-valve prosthesis in the mitral position due to interference by papillary muscle. Diagnostic and surgical considerations.

The frequency of prosthetic heart valve malfunction caused by intrinsic factors has been markedly decreased by refinements of prosthetic design and by improved quality of the prosthetic material. Nevertheless, a variety of extrinsic factors, i.e. thrombus formation, bacterial endocarditis, inadequate suture technique and papillary muscle entrapment, are known to be responsible for mechanical malfunctions of prosthetic heart valves, occasionally leading to sudden cardiac death. In this report, a case of intermittent entrapment of papillary muscle in the Omnicarbon valve is presented; diagnostic and surgical aspects are discussed.

Aortic Valve↗

PubMed1989

The effect of halothane, enflurane, and isoflurane on the dynamic stiffness of rabbit papillary muscle.

The authors examined the effect of halothane, enflurane, and isoflurane on the dynamic stiffness of rabbit papillary muscles in Ba2+ contracture. Ca2+ was replaced by Ba2+ in order to constantly activate myofibrils. The dynamic stiffness of the contractured muscle was examined by exposing the muscle to sinusoidal length perturbations at frequencies of 0.05-30 Hz under two concentrations of anesthetic, approximately 0.5, and 1.5-2 mM, and at two Ba2+ concentrations, 0.5 and 1.5-2 mM. The anesthetics had no effect on the frequency (fmin) at which minimum stiffness occurred, but markedly decreased the stiffness modulus at high frequencies (Khi). The decrease in Khi was significant for all anesthetics at the P less than 0.05 level. Increasing the Ba2+ concentration from 0.5 to 1.5-2 mM in the presence of 0.5 mM of anesthetic resulted in a return of Khi to control levels. The authors conclude that halothane, enflurane, and isoflurane did not alter actin-myosin ATPase kinetics, because fmin was unchanged, but decreased the number of crossbridge interactions, because Khi was significantly decreased by all three anesthetics.

Animals↗

PubMed1996

[Effects of 2-(p-dimethylaminostyryl) pyridine methycholide (DSPM-Ci) on ECG, left atrium contractivity and on papillary muscle action potentials].

The effects of DSPM-Cl on ECG in rats, on the dose-effect curve in guinea pig left atria and on the fast action potential (AP), high-K+ depolarized slow action potential (SAP) in guinea pigs papillary muscle were examined electrophysiologically. DSPM-Cl (2 mg.kg-1) showed significant nagative frequency, negative conductivity effect, and prolonged the PP and PR interval. DSPM-CI (30-50 mumol.L-1) was shown to inhibit left atria contractility and shift the concentration-response curve of Iso and CaCl2 to the right with PD2' values of 4.60 and 4.13, respectively. In addition, DSPM-Cl was found to prolong the duration of action potential 90 (APD90) and effective refractory period (ERP), and decrease the maximal upstroke velocity (Vmax) in K(+)-depolarized guinea pigs papillary muscles. The results suggest that, like verpamil, DSPM-Cl might be a calcium antagonist.

Action Potentials↗

PubMed2004

Impact of papillary muscles in ventricular volume and ejection fraction assessment by cardiovascular magnetic resonance.

Cardiovascular magnetic resonance (CMR) is an accurate tool for the determination of right and left ventricular volumes and ejection fractions. However, the current standard short-axis technique is time-consuming and thus, often not practicable for routine daily use, because papillary muscles and trabeculations have to be marked and their volumes subtracted from the total ventricular volume. To reduce calculation time we evaluated the volumetric data that included papillary muscle and trabecular volumes and compared the outcome with the results of the standard technique. Thirty patients (17 healthy, 13 with coronary heart disease) were examined by CMR using TrueFISP (Magnetom, Siemens, Erlangen, Germany). Right and left ventricular volumes and ejection fractions were calculated using the standard short-axis technique and then again without subtracting papillary and trabecular volumes. The two methods were compared by determining the differences in results for ventricular volumes and ejection fractions. Statistically significant differences were found between the two methods for right and left ventricular stroke volumes and end-systolic volumes, and left ventricular end-diastolic volumes (EDV) (p < or = 0.011). No significant difference was found for right ventricular end-diastolic volumes (p > or = 0.149) or left or right ventricular ejection fraction (p > or = 0.130). Except in the case of left ventricular EDV, the deviations in the results of method 1 and method 2 did not vary significantly with the presence or absence of heart disease. Measurements were obtained considerably more quickly with the modified method than with the standard short-axis method (25 +/- 4 min vs. 13 +/- 3 min, p = 0.000). Although systematic differences were found when papillary and trabecular volumes were not subtracted, these differences are small and may not be of clinical relevance in healthy subjects or patients with coronary heart disease. Not subtracting the volumes of these structures enables faster determination of right and left ventricular volumes and ejection fractions without loss of the accuracy associated with the standard short-axis technique.

Adult↗

PubMed2000

Effects of a selective inhibitor of Na+/Ca2+ exchange, KB-R7943, on reoxygenation-induced injuries in guinea pig papillary muscles.

The effects of a novel agent that is reported to selectively block Ca2+ influx by Na+/Ca2+ exchange (NCX), KB-R7943, on the reoxygenation-induced arrhythmias and the recovery of developed tension after reoxygenation, were investigated in guinea pig papillary muscles. KB-R7943 dose-dependently suppressed the contracture tension during low-sodium (21.9 mM) perfusion (23+/-8% of steady-state developed tension at 10 microM vs. 56+/-11% in control; n = 6, p<0.05), but did not change action potential and contractile parameters. During the reoxygenation period after 60-min substrate-free hypoxia, KB-R7943 (10 microM) significantly decreased the incidence of arrhythmias (44 vs. 100% in control; n = 9, p <0.05) and shortened the duration of arrhythmias (16+/-11 vs. 72+/-14 s; p<0.01). KB-R7943 (10 microM) significantly enhanced the recovery of developed tension after reoxygenation (83+/-4 vs. 69+/-3% in control; p<0.05). We conclude that KB-R7943 (10 microM) selectively inhibits the reverse mode of NCX, and that it attenuates reoxygenation-induced arrhythmic activity and prevents contractile dysfunction in guinea pig papillary muscles. These results suggest that Ca2+ influx by NCX may play a key role in reoxygenation injury.

Action Potentials↗

PubMed1977

[Effect of free fatty acids on the heart: effects of nonanoic acid on contractility and postextrasystolic potentiation in the rat papillary muscle].

1. Nonanoic acid causes a depression in the contractile force of rat papillary muscles working isometrically. The effect depends on both the concentration of the fatty acid (0.1-1 mM) and the time of exposure (2-12 min), and shows a nearly complete reversibility. 2. Vmax-values derived from the force-velocity relation as well as the index of relation suggested by Meerson do not change in muscles exposed to nonanoic acid. During paired pulse stimulation with a 400 ms-delay of the second impulse, both the postextrasystolic potentiation and the time to reach a new steady level in the contraction amplitude are significantly increased. The speed of restituting the contraction after a twitch (resitution) is descreased. 4. The results suggest that the action site of nonanoic acid may be the excitation-contraction coupling system (including the action potential) rather than the contractile element or the relaxation of the muscle.

Action Potentials↗

PubMed1989

Comparative effects of tetrodotoxin, lidocaine, and amiodarone on Vmax in guinea pig cardiac Purkinje and papillary muscle fibers.

1. Electrophysiological effects of three drugs (tetrodotoxin, lidocaine, and amiodarone), which are known to depress Na channels in cardiac tissues, were studied on isolated guinea pig Purkinje fibers, by means of microelectrode techniques, and compared the findings with their effects on the ventricular papillary muscle. 2. Special attention was paid with regard to their effects on the maximum upstroke velocity (Vmax) of action potentials. 3. In Purkinje fibers, tetrodotoxin was the most inhibitory for Vmax, then in descending order, amiodarone, and lidocaine. 4. That is, half maximal inhibition (IC50) of Vmax by tetrodotoxin, lidocaine and amiodarone was approximately 1.7 x 10(-5) M, 1.5 x 10(-4) M and 2.8 x 10(-4) M, respectively. 5. As for papillary muscle, higher concentrations of the three drugs were needed to get similar potency. 6. The relationships between the depression in the Vmax and action potential duration are discussed in conjunction with their antiarrhythmic activities.

Action Potentials↗

PubMed1983

Tension development of normal and hypertrophied-failing papillary muscles following rapid stimulation.

Recent studies have shown that numerous cellular alterations exist in hypertrophied-failing (HF) cardiac muscle. Of particular interest is the finding of an altered ability of the Na-K pump to regulate membrane potential in this tissue during periods of transient stimulation. The present study was designed to determine if this altered Na-K pump function is in any way related to the ability of this tissue to develop force. Along these lines the rate of stimulation (6/min) of normal and hypertrophied-failing right ventricular papillary muscles from cats was increased to 60/min for 90 sec. This procedure was repeated in solutions with low Na+, low Na+ and Ca++, and Ouabain. These solutions were utilized to vary the ionic load on the Na-K pump and the Na-Ca exchanger. The results demonstrate that the pattern of changes in tension in HF papillary muscles seen following periods of rapid stimulation are significantly different from those of normal muscles. The pattern of changes in mechanical performance were found to be similar to the membrane potential changes described in previous studies. In addition, lowering the Na+ load presented to HF muscles returned the characteristic pattern of changes in tension, following drive, toward normal. Ouabain was found to inhibit the changes in tension development following increased rates of stimulation that are thought to be produced by activation of the Na-K pump. The results suggest that the ability of the Na-K pump to maintain normal transmembrane ionic gradients may be altered in HF muscles. This alteration appears to be capable of affecting cellular Ca++ possibly through the Na-Ca exchange system.

Animals↗

PubMed1986

Two components of contraction in guinea pig papillary muscle.

Biphasic contractions were produced in guinea pig papillary muscle by inducing partial depolarization in a K+ -rich solution (22 mM) containing 10(-6) M isoproterenol. However, when the same conditions were applied to frog and rat, monophasic contractions were obtained. In the case of guinea pig, an increase in the beating frequency produced an increase in amplitude of the first component and a reduction of the second, while in frog and rat, only a decrease in the amplitude of contractions was recorded. Caffeine (10(-3) M) eliminated the first component and increased the second in guinea pig, while in the case of rat and frog it decreased the amplitude of contractions. Procaine (10(-3) M) suppressed the first component and decreased the second one. The contraction in frog appears to be similar to the second component of contraction in guinea pig, while in rat, the contraction is comparable with the first component in guinea pig. It is suggested that the calcium ions which activate the two components of contraction in guinea pig under the given experimental conditions may arise from two different sources.

Action Potentials↗

PubMed1997

Inhibition of S-adenosyl-L-homocysteine hydrolase by adrenaline in isolated guinea-pig papillary muscles.

Purified S-adenosyl-L-homocysteine hydrolase from Dictyostelium discoideum or rabbit erythrocytes is inactivated when incubated with cAMP. The aim of this study was to investigate whether adrenaline, which increases cytosolic cAMP and calcium concentrations, is able to modify in situ the activity of S-adenosyl-L-homocysteine hydrolase in the heart. The enzyme was assayed in a crude extract obtained from superfused guinea-pig papillary muscles with the different tested substances. Adrenaline was found to inhibit S-adenosyl-L-homocysteine hydrolase in papillary muscles in a concentration-dependent fashion. This inhibition was associated with an increase in the concentration of S-adenosyl-L-homocysteine (326%), and a decrease of adenosine (40%). beta-Adrenoceptors are involved in the effect of adrenaline, since isoproterenol, a beta-adrenergic agonist, inhibited the enzyme, whereas the beta-adrenergic blocker, propranolol, prevented this inhibition. Participation of calcium in the inhibitory effect of adrenaline was suggested because the calcium channel blocker, verapamil, suppressed this inhibition, and high calcium in the perfusion medium inhibited the enzyme. In vitro experiments with calcium were performed in a semi-purified fraction of the enzyme, resulting in a concentration-dependent inhibition of the enzyme. Calcium concentration, which inhibited the enzyme 50%, was in the millimolar range for control and in the micromolar range for the obtained enzyme from adrenaline-treated muscles, indicating a different sensitivity to calcium inhibition. We conclude that adrenaline inhibits S-adenosyl-L-homocysteine hydrolase in situ, probably by a calcium-modulated mechanism.

Adenosylhomocysteinase↗

PubMed1978

Correlation between inhibition of (Na+, K+)-membrane-ATPase and positive inotropic activity of cardenolides in isolated papillary muscles of guinea pig.

Concentrations of 17 cardenolides, cardenolide glucuronides and sulfates producing half-maximal inhibition of (Na+, K+)-membrane-ATPase from different organs and animal species were determined in vitro. In addition the concentrations that increased the contractility of guinea pig isolated papillary muscles to a particular level were investigated. Comparisons between ATPase-inhibiting and positive inotropic cardiac activities showed extensive parallelism: the correlation coefficients after log/log transformation were between 0.92 and 0.97. The same close correlations are found if dissociation constants of cardenolide receptor complexes and concentrations causing 86Rb-uptake inhibition in human erythrocytes are examined. The concentrations necessary for inhibition of (Na+, K+)-membrane-ATPase of the guinea pig heart and the concentrations required to achieve a defined positive inotropic effect in guinea pig papillary muscle showed a log/log correlation coefficient of 0.97 (P less than 0.001). In both tests the potencies covered more than three orders of magnitude. The results support Repke's hypothesis on the digitalis receptor.

Animals↗