Conical muscular projections from the walls of the cardiac ventricles, attached to the cusps of the atrioventricular valves by the chordae tendineae.
Contractile tissue that produces movement in animals.
Contractile activity of the MYOCARDIUM.
The protein constituents of muscle, the major ones being ACTINS and MYOSINS. More than a dozen accessory proteins exist including TROPONIN; TROPOMYOSIN; and DYSTROPHIN.
The tendinous cords that connect each cusp of the two atrioventricular HEART VALVES to appropriate PAPILLARY MUSCLES in the HEART VENTRICLES, preventing the valves from reversing themselves when the ventricles contract.
Unstriated and unstriped muscle, one of the muscles of the internal organs, blood vessels, hair follicles, etc. Contractile elements are elongated, usually spindle-shaped cells with centrally located nuclei. Smooth muscle fibers are bound together into sheets or bundles by reticular fibers and frequently elastic nets are also abundant. (From Stedman, 25th ed)
A subtype of striated muscle, attached by TENDONS to the SKELETON. Skeletal muscles are innervated and their movement can be consciously controlled. They are also called voluntary muscles.
A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments.
Large, multinucleate single cells, either cylindrical or prismatic in shape, that form the basic unit of SKELETAL MUSCLE. They consist of MYOFIBRILS enclosed within and attached to the SARCOLEMMA. They are derived from the fusion of skeletal myoblasts (MYOBLASTS, SKELETAL) into a syncytium, followed by differentiation.
The nonstriated involuntary muscle tissue of blood vessels.
Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation.
A common name used for the genus Cavia. The most common species is Cavia porcellus which is the domesticated guinea pig used for pets and biomedical research.
Developmental events leading to the formation of adult muscular system, which includes differentiation of the various types of muscle cell precursors, migration of myoblasts, activation of myogenesis and development of muscle anchorage.
The valve between the left atrium and left ventricle of the heart.
The hollow, muscular organ that maintains the circulation of the blood.
Semidomesticated variety of European polecat much used for hunting RODENTS and/or RABBITS and as a laboratory animal. It is in the subfamily Mustelinae, family MUSTELIDAE.
Abrupt changes in the membrane potential that sweep along the CELL MEMBRANE of excitable cells in response to excitation stimuli.
The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.
The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow.
A state arrived at through prolonged and strong contraction of a muscle. Studies in athletes during prolonged submaximal exercise have shown that muscle fatigue increases in almost direct proportion to the rate of muscle glycogen depletion. Muscle fatigue in short-term maximal exercise is associated with oxygen lack and an increased level of blood and muscle lactic acid, and an accompanying increase in hydrogen-ion concentration in the exercised muscle.
Skeletal muscle fibers characterized by their expression of the Type II MYOSIN HEAVY CHAIN isoforms which have high ATPase activity and effect several other functional properties - shortening velocity, power output, rate of tension redevelopment. Several fast types have been identified.
The resection or removal of the innervation of a muscle or muscle tissue.
Muscular contractions characterized by increase in tension without change in length.
Skeletal muscle fibers characterized by their expression of the Type I MYOSIN HEAVY CHAIN isoforms which have low ATPase activity and effect several other functional properties - shortening velocity, power output, rate of tension redevelopment.
A photoprotein isolated from the bioluminescent jellyfish Aequorea. It emits visible light by an intramolecular reaction when a trace amount of calcium ion is added. The light-emitting moiety in the bioluminescence reaction is believed to be 2-amino-3-benzyl-5-(p-hydroxyphenyl)pyrazine (AF-350).
Laceration or tearing of cardiac tissues appearing after MYOCARDIAL INFARCTION.
Non-striated, elongated, spindle-shaped cells found lining the digestive tract, uterus, and blood vessels. They are derived from specialized myoblasts (MYOBLASTS, SMOOTH MUSCLE).
A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes.
That phase of a muscle twitch during which a muscle returns to a resting position.
Mitochondria of skeletal and smooth muscle. It does not include myocardial mitochondria for which MITOCHONDRIA, HEART is available.
The species Oryctolagus cuniculus, in the family Leporidae, order LAGOMORPHA. Rabbits are born in burrows, furless, and with eyes and ears closed. In contrast with HARES, rabbits have 22 chromosome pairs.
Use of electric potential or currents to elicit biological responses.
Motion picture study of successive images appearing on a fluoroscopic screen.
The neck muscles consist of the platysma, splenius cervicis, sternocleidomastoid(eus), longus colli, the anterior, medius, and posterior scalenes, digastric(us), stylohyoid(eus), mylohyoid(eus), geniohyoid(eus), sternohyoid(eus), omohyoid(eus), sternothyroid(eus), and thyrohyoid(eus).
Disease-related laceration or tearing of tissues of the heart, including the free-wall MYOCARDIUM; HEART SEPTUM; PAPILLARY MUSCLES; CHORDAE TENDINEAE; and any of the HEART VALVES. Pathological rupture usually results from myocardial infarction (HEART RUPTURE, POST-INFARCTION).
The muscles that move the eye. Included in this group are the medial rectus, lateral rectus, superior rectus, inferior rectus, inferior oblique, superior oblique, musculus orbitalis, and levator palpebrae superioris.
One of two types of muscle in the body, characterized by the array of bands observed under microscope. Striated muscles can be divided into two subtypes: the CARDIAC MUSCLE and the SKELETAL MUSCLE.
The decrease in a measurable parameter of a PHYSIOLOGICAL PROCESS, including cellular, microbial, and plant; immunological, cardiovascular, respiratory, reproductive, urinary, digestive, neural, musculoskeletal, ocular, and skin physiological processes; or METABOLIC PROCESS, including enzymatic and other pharmacological processes, by a drug or other chemical.
Skeletal muscle structures that function as the MECHANORECEPTORS responsible for the stretch or myotactic reflex (REFLEX, STRETCH). They are composed of a bundle of encapsulated SKELETAL MUSCLE FIBERS, i.e., the intrafusal fibers (nuclear bag 1 fibers, nuclear bag 2 fibers, and nuclear chain fibers) innervated by SENSORY NEURONS.
The domestic cat, Felis catus, of the carnivore family FELIDAE, comprising over 30 different breeds. The domestic cat is descended primarily from the wild cat of Africa and extreme southwestern Asia. Though probably present in towns in Palestine as long ago as 7000 years, actual domestication occurred in Egypt about 4000 years ago. (From Walker's Mammals of the World, 6th ed, p801)
Modified cardiac muscle fibers composing the terminal portion of the heart conduction system.
Elements of limited time intervals, contributing to particular results or situations.
These include the muscles of the DIAPHRAGM and the INTERCOSTAL MUSCLES.
Isopropyl analog of EPINEPHRINE; beta-sympathomimetic that acts on the heart, bronchi, skeletal muscle, alimentary tract, etc. It is used mainly as bronchodilator and heart stimulant.
A vague complaint of debility, fatigue, or exhaustion attributable to weakness of various muscles. The weakness can be characterized as subacute or chronic, often progressive, and is a manifestation of many muscle and neuromuscular diseases. (From Wyngaarden et al., Cecil Textbook of Medicine, 19th ed, p2251)
The hemodynamic and electrophysiological action of the HEART VENTRICLES.
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
The long cylindrical contractile organelles of STRIATED MUSCLE cells composed of ACTIN FILAMENTS; MYOSIN filaments; and other proteins organized in arrays of repeating units called SARCOMERES .
A type of heart valve surgery that involves the repair, replacement, or reconstruction of the annulus of the MITRAL VALVE. It includes shortening the circumference of the annulus to improve valve closing capacity and reinforcing the annulus as a step in more complex valve repairs.
The voltage differences across a membrane. For cellular membranes they are computed by subtracting the voltage measured outside the membrane from the voltage measured inside the membrane. They result from differences of inside versus outside concentration of potassium, sodium, chloride, and other ions across cells' or ORGANELLES membranes. For excitable cells, the resting membrane potentials range between -30 and -100 millivolts. Physical, chemical, or electrical stimuli can make a membrane potential more negative (hyperpolarization), or less negative (depolarization).
The innermost layer of the heart, comprised of endothelial cells.
Muscles forming the ABDOMINAL WALL including RECTUS ABDOMINIS, external and internal oblique muscles, transversus abdominis, and quadratus abdominis. (from Stedman, 25th ed)
The quadriceps femoris. A collective name of the four-headed skeletal muscle of the thigh, comprised of the rectus femoris, vastus intermedius, vastus lateralis, and vastus medialis.
Mature contractile cells, commonly known as myocytes, that form one of three kinds of muscle. The three types of muscle cells are skeletal (MUSCLE FIBERS, SKELETAL), cardiac (MYOCYTES, CARDIAC), and smooth (MYOCYTES, SMOOTH MUSCLE). They are derived from embryonic (precursor) muscle cells called MYOBLASTS.
The study of the generation and behavior of electrical charges in living organisms particularly the nervous system and the effects of electricity on living organisms.
The circulation in a portion of the body of one individual of blood supplied from another individual.
The properties, processes, and behavior of biological systems under the action of mechanical forces.
A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain.
A masticatory muscle whose action is closing the jaws.
A group of diseases in which the dominant feature is the involvement of the CARDIAC MUSCLE itself. Cardiomyopathies are classified according to their predominant pathophysiological features (DILATED CARDIOMYOPATHY; HYPERTROPHIC CARDIOMYOPATHY; RESTRICTIVE CARDIOMYOPATHY) or their etiological/pathological factors (CARDIOMYOPATHY, ALCOHOLIC; ENDOCARDIAL FIBROELASTOSIS).
Agents used for the treatment or prevention of cardiac arrhythmias. They may affect the polarization-repolarization phase of the action potential, its excitability or refractoriness, or impulse conduction or membrane responsiveness within cardiac fibers. Anti-arrhythmia agents are often classed into four main groups according to their mechanism of action: sodium channel blockade, beta-adrenergic blockade, repolarization prolongation, or calcium channel blockade.
Muscles of facial expression or mimetic muscles that include the numerous muscles supplied by the facial nerve that are attached to and move the skin of the face. (From Stedman, 25th ed)
Muscles arising in the zygomatic arch that close the jaw. Their nerve supply is masseteric from the mandibular division of the trigeminal nerve. (From Stedman, 25th ed)
The increase in a measurable parameter of a PHYSIOLOGICAL PROCESS, including cellular, microbial, and plant; immunological, cardiovascular, respiratory, reproductive, urinary, digestive, neural, musculoskeletal, ocular, and skin physiological processes; or METABOLIC PROCESS, including enzymatic and other pharmacological processes, by a drug or other chemical.
Respiratory muscles that arise from the lower border of one rib and insert into the upper border of the adjoining rib, and contract during inspiration or respiration. (From Stedman, 25th ed)
Recording of the changes in electric potential of muscle by means of surface or needle electrodes.
A cardioactive glycoside consisting of rhamnose and ouabagenin, obtained from the seeds of Strophanthus gratus and other plants of the Apocynaceae; used like DIGITALIS. It is commonly used in cell biological studies as an inhibitor of the NA(+)-K(+)-EXCHANGING ATPASE.
An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart.
Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation.
Electrodes with an extremely small tip, used in a voltage clamp or other apparatus to stimulate or record bioelectric potentials of single cells intracellularly or extracellularly. (Dorland, 28th ed)
Elongated, spindle-shaped, quiescent myoblasts lying in close contact with adult skeletal muscle. They are thought to play a role in muscle repair and regeneration.
A methylpyrrole-carboxylate from RYANIA that disrupts the RYANODINE RECEPTOR CALCIUM RELEASE CHANNEL to modify CALCIUM release from SARCOPLASMIC RETICULUM resulting in alteration of MUSCLE CONTRACTION. It was previously used in INSECTICIDES. It is used experimentally in conjunction with THAPSIGARGIN and other inhibitors of CALCIUM ATPASE uptake of calcium into SARCOPLASMIC RETICULUM.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
The relationship between the dose of an administered drug and the response of the organism to the drug.
The excitable plasma membrane of a muscle cell. (Glick, Glossary of Biochemistry and Molecular Biology, 1990)
A network of tubules and sacs in the cytoplasm of SKELETAL MUSCLE FIBERS that assist with muscle contraction and relaxation by releasing and storing calcium ions.
Tear or break of an organ, vessel or other soft part of the body, occurring in the absence of external force.
An order of MAMMALS, usually flesh eaters with appropriate dentition. Suborders include the terrestrial carnivores Fissipedia, and the aquatic carnivores PINNIPEDIA.
The pectoralis major and pectoralis minor muscles that make up the upper and fore part of the chest in front of the AXILLA.
Drugs that selectively bind to and activate beta-adrenergic receptors.
The period of time following the triggering of an ACTION POTENTIAL when the CELL MEMBRANE has changed to an unexcitable state and is gradually restored to the resting (excitable) state. During the absolute refractory period no other stimulus can trigger a response. This is followed by the relative refractory period during which the cell gradually becomes more excitable and the stronger impulse that is required to illicit a response gradually lessens to that required during the resting state.
Agents that have a strengthening effect on the heart or that can increase cardiac output. They may be CARDIAC GLYCOSIDES; SYMPATHOMIMETICS; or other drugs. They are used after MYOCARDIAL INFARCT; CARDIAC SURGICAL PROCEDURES; in SHOCK; or in congestive heart failure (HEART FAILURE).
The larger subunits of MYOSINS. The heavy chains have a molecular weight of about 230 kDa and each heavy chain is usually associated with a dissimilar pair of MYOSIN LIGHT CHAINS. The heavy chains possess actin-binding and ATPase activity.
Echocardiography amplified by the addition of depth to the conventional two-dimensional ECHOCARDIOGRAPHY visualizing only the length and width of the heart. Three-dimensional ultrasound imaging was first described in 1961 but its application to echocardiography did not take place until 1974. (Mayo Clin Proc 1993;68:221-40)
Acquired, familial, and congenital disorders of SKELETAL MUSCLE and SMOOTH MUSCLE.
Abnormal protrusion or billowing of one or both of the leaflets of MITRAL VALVE into the LEFT ATRIUM during SYSTOLE. This allows the backflow of blood into left atrium leading to MITRAL VALVE INSUFFICIENCY; SYSTOLIC MURMURS; or CARDIAC ARRHYTHMIA.
A cardiac glycoside sometimes used in place of DIGOXIN. It has a longer half-life than digoxin; toxic effects, which are similar to those of digoxin, are longer lasting. (From Martindale, The Extra Pharmacopoeia, 30th ed, p665)
A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.
An optical isomer of quinine, extracted from the bark of the CHINCHONA tree and similar plant species. This alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. It prolongs cellular ACTION POTENTIALS, and decreases automaticity. Quinidine also blocks muscarinic and alpha-adrenergic neurotransmission.
Treatment process involving the injection of fluid into an organ or tissue.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues using a transducer placed in the esophagus.
An element in the alkali group of metals with an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the WATER-ELECTROLYTE BALANCE.
Surgical insertion of synthetic material to repair injured or diseased heart valves.
A powerful flexor of the thigh at the hip joint (psoas major) and a weak flexor of the trunk and lumbar spinal column (psoas minor). Psoas is derived from the Greek "psoa", the plural meaning "muscles of the loin". It is a common site of infection manifesting as abscess (PSOAS ABSCESS). The psoas muscles and their fibers are also used frequently in experiments in muscle physiology.
Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES).
Cells propagated in vitro in special media conducive to their growth. Cultured cells are used to study developmental, morphologic, metabolic, physiologic, and genetic processes, among others.
An adrenergic beta-agonist used as a bronchodilator agent in asthma therapy.
Carrier of aroma of butter, vinegar, coffee, and other foods.
A polymer prepared from polyvinyl acetates by replacement of the acetate groups with hydroxyl groups. It is used as a pharmaceutic aid and ophthalmic lubricant as well as in the manufacture of surface coatings artificial sponges, cosmetics, and other products.
A highly poisonous compound that is an inhibitor of many metabolic processes and is used as a test reagent for the function of chemoreceptors. It is also used in many industrial processes.
Germine derivatives acetylated on any one or more of the hydroxy groups. These compounds are present in many polyester alkaloids which occur in Veratrum and Zygadenus species. They are used as antihypertensive agents, and in some cases, exhibit curare-like activity.
A form of CARDIAC MUSCLE disease, characterized by left and/or right ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR; HYPERTROPHY, RIGHT VENTRICULAR), frequent asymmetrical involvement of the HEART SEPTUM, and normal or reduced left ventricular volume. Risk factors include HYPERTENSION; AORTIC STENOSIS; and gene MUTATION; (FAMILIAL HYPERTROPHIC CARDIOMYOPATHY).
A highly toxic saponin occurring in HOLOTHUROIDEA. This marine toxin is an anionic surfactant, hemolyzing ERYTHROCYTES.
A masticatory muscle whose action is closing the jaws; its posterior portion retracts the mandible.
This structure includes the thin muscular atrial septum between the two HEART ATRIA, and the thick muscular ventricular septum between the two HEART VENTRICLES.
Either of two extremities of four-footed non-primate land animals. It usually consists of a FEMUR; TIBIA; and FIBULA; tarsals; METATARSALS; and TOES. (From Storer et al., General Zoology, 6th ed, p73)
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
An adrenergic-beta-2 antagonist that has been used for cardiac arrhythmia, angina pectoris, hypertension, glaucoma, and as an antithrombotic.
The number of times the HEART VENTRICLES contract per unit of time, usually per minute.
A class of drugs that act by selective inhibition of calcium influx through cellular membranes.
Any of the ruminant mammals with curved horns in the genus Ovis, family Bovidae. They possess lachrymal grooves and interdigital glands, which are absent in GOATS.
The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance.
A calcium channel blocker that is a class IV anti-arrhythmia agent.
An alkaloid found in the roots of Rauwolfia serpentina and R. vomitoria. Reserpine inhibits the uptake of norepinephrine into storage vesicles resulting in depletion of catecholamines and serotonin from central and peripheral axon terminals. It has been used as an antihypertensive and an antipsychotic as well as a research tool, but its adverse effects limit its clinical use.
The repeating contractile units of the MYOFIBRIL, delimited by Z bands along its length.
A member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23.
A positive inotropic cardiotonic (CARDIOTONIC AGENTS) with vasodilator properties, phosphodiesterase 3 inhibitory activity, and the ability to stimulate calcium ion influx into the cardiac cell.
The measurement of an organ in volume, mass, or heaviness.
A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs.
Surgery performed on the heart.
A purely physical condition which exists within any material because of strain or deformation by external forces or by non-uniform thermal expansion; expressed quantitatively in units of force per unit area.
Relatively complete absence of oxygen in one or more tissues.

Automatic activity in depolarized guinea pig ventricular myocardium. Characteristics and mechanisms. (1/1104)

Membrane potential was changed uniformly in segments, 0.7-1.0 mm long, of guinea pig papillary muscles excised from the right ventricle by using extracellular polarizing current pulses applied across two electrically insulated cf preparations superfused with Tyrode's solution at maximum diastolic membrane potentials ranging from-35.2+/-7.5 (threshold) to +4.0+/-9.2 mV. The average maximum dV/dt of RAD ranged from 17.1 to 18.0 V/sec within a membrane potential range of -40 to +20 mV. Raising extracellular Ca2+ concentration [Ca2+]0 from 1.8 to 6.8 mM, or application of isoproterenol (10(-6)g/ml) enhanced the rate of RAD, but lowering [Ca2+]0 to 0.4 mM or exposure to MnCl2 (6 mM) abolished RAD. RAD were enhanced by lowering extracellular K+ concentration [K+]0 from 5.4 to 1.5 mM. RAD were suppressed in 40% of fibers by raising [K+]0 to 15.4 mM, and in all fibers by raising [K+]0 to 40.4 mM. This suppression was due to increased [K+]0 and not to K-induced depolarization because it persisted when membrane potential was held by means of a conditioning hyperpolarizing puled gradually after maximum repolarization. These observations suggest that the development of RAD in depolarized myocardium is associated with a time-dependent decrease in outward current (probably K current) and with increase in the background inward current, presumably flowing through the slow cha-nel carrying Ca or Na ions, or both.  (+info)

Simultaneous assessment of effects of coronary vasodilators on the coronary blood flow and the myocardial contractility by using the blood-perfused canine papillary muscle. (2/1104)

Effects of 6 coronary vasodilators on the coronary blood flow and the contractile force of the ventricular muscle were examined simultaneously by injecting these drugs to the arterially blood-perfused canine papillary muscle preparation. All compounds produced a dose-dependent increase in blood flow rate, and relative potencies determined on the basis of doses producing a 100% increase in blood flow rate, ED100, were in the descending order : nifedipine greater than verapamil greater than diltiazem greater than dilazep greater than dipyridamole greater than carbochromen, and approximately 1 : 1/12 : 1/26 : 1/100 : 1/300 : 1/500. All drugs except for dipyridamole caused a dose-dependent decrease in the developed tension of the papillary muscle, although nifedipine and diltiazem in low doses produced a slight increase. Relative potencies determined on the basis of doses producing a 50% decrease in developed tension, ID50, were as follows: nifedipine (1), verapamil (1/13), diltiazem (1/40), dilazep (1/100), and carbochromen (1/270). Ratios of the ID50 to ED100 were as follows: diltiazem (5.2), nifedipine (3.5), verapamil (3.5), dilazep (2.5), and carbochromen (1.8). The higher the value the more predominant on the coronary vascular bed or the less depressant on the myocardial contractility were their actions.  (+info)

Electrical and mechanical responses to diltiazem in potassium depolarized myocardium of the guinea pig. (3/1104)

Effects of diltiazem on the electrical and mechanical activities of guinea pig papillary muscle were investigated in K-rich Tyrode's solution (Kc1 12.7 mM). The electrical properties of cell membrane in K-rich solution were also examined in the ventricular muscle fibers. It was found that the overshoot as well as the maximum rate of rise (Vmax) of the action potential were highly sensitive to the extracellular concentration of CaC12 in K-rich solution. Vmax was also affected by NaC1. Diltiazem at a lower concentration (1.1 X 10(-7) M) caused a reduction in the contractile force of K-depolarized papillary muscle without producing significant changes in the resting and action potentials. In the presence of a higher concentration of diltiazem (1.1 X 10(-5) M), the contractile force decreased concurrently with the change in the action potential. Addition of CaC12 restored the original strength of contraction in parallel to the recovery of the action potential, especially in its overshoot and Vmax. From these results, it is inferred that diltiazem may decrease the contractile force of guinea pig papillary muscle either by interfering with the intrasmembrane calcium influx or by intracellularly reducing the free calcium ion concentration in the myoplasm.  (+info)

Altered crossbridge kinetics in the alphaMHC403/+ mouse model of familial hypertrophic cardiomyopathy. (4/1104)

A mutation in the cardiac beta-myosin heavy chain, Arg403Gln (R403Q), causes a severe form of familial hypertrophic cardiomyopathy (FHC) in humans. We used small-amplitude (0.25%) length-perturbation analysis to examine the mechanical properties of skinned left ventricular papillary muscle strips from mouse hearts bearing the R403Q mutation in the alpha-myosin heavy chain (alphaMHC403/+). Myofibrillar disarray with variable penetrance occurred in the left ventricular free wall of the alphaMHC403/+ hearts. In resting strips (pCa 8), dynamic stiffness was approximately 40% greater than in wild-type strips, consistent with elevated diastolic stiffness reported for murine hearts with FHC. At pCa 6 (submaximal activation), strip isometric tension was approximately 3 times higher than for wild-type strips, whereas at pCa 5 (maximal activation), tension was marginally lower. At submaximal calcium activation the characteristic frequencies of the work-producing (b) and work-absorbing (c) steps of the crossbridge were less in alphaMHC403/+ strips than in wild-type strips (b=11+/-1 versus 15+/-1 Hz; c= 58+/-3 versus 66+/-3 Hz; 27 degrees C). At maximal calcium activation, strip oscillatory power was reduced (0. 53+/-0.25 versus 1.03+/-0.18 mW/mm3; 27 degrees C), which is partly attributable to the reduced frequency b, at which crossbridge work is maximum. The results are consistent with the hypothesis that the R403Q mutation reduces the strong binding affinity of myosin for actin. Myosin heads may accumulate in a preforce state that promotes cooperative activation of the thin filament at submaximal calcium but blunts maximal tension and oscillatory power output at maximal calcium. The calcium-dependent effect of the mutation (whether facilitating or debilitating), together with a variable degree of fibrosis and myofibrillar disorder, may contribute to the diversity of clinical symptoms observed in murine FHC.  (+info)

Phospholamban-to-SERCA2 ratio controls the force-frequency relationship. (5/1104)

The force-frequency relationship (FFR) describes the frequency-dependent potentiation of cardiac contractility. The interaction of the sarcoplasmic reticulum Ca2+-adenosinetriphosphatase (SERCA2) with its inhibitory protein phospholamban (PLB) might be involved in the control of the FFR. The FFR was analyzed in two systems in which the PLB-to-SERCA2 ratio was modulated. Adult rabbit cardiac myocytes were transduced with adenovirus encoding for SERCA2, PLB, and beta-galactosidase (control). After 3 days, the relative PLB/SERCA2 values were significantly different between groups (SERCA2, 0.5; control, 1.0; PLB, 4.5). SERCA2 overexpression shortened relaxation by 23% relative to control, whereas PLB prolonged relaxation by 39% and reduced contractility by 47% (0.1 Hz). When the stimulation frequency was increased to 1.5 Hz, myocyte contractility was increased by 30% in control myocytes. PLB-overexpressing myocytes showed an augmented positive FFR (+78%), whereas SERCA2-transduced myocytes displayed a negative FFR (-15%). A more negative FFR was also found in papillary muscles from SERCA2 transgenic mice. These findings demonstrate that the ratio of phospholamban to SERCA2 is an important component in the control of the FFR.  (+info)

Effects of AT1 receptor blockade after myocardial infarct on myocardial fibrosis, stiffness, and contractility. (6/1104)

Angiotensin II type 1 (AT1) receptor blockade attenuates myocardial fibrosis after myocardial infarction (MI). However, whether inhibition of fibrosis by AT1 receptor blockade influences myocardial stiffness and contractility is unknown. We measured left ventricular (LV) hemodynamics, papillary muscle function, and myocardial stiffness and fibrosis in rats randomized to losartan or placebo 1 day after MI and treated subsequently for 8 wk. Losartan decreased LV and right ventricular weights as well as mean aortic and LV systolic pressures in sham and MI rats. LV end-diastolic pressure increased after MI and was decreased with losartan. Maximal developed tension and peak rate of tension rise and decline were decreased in MI vs. sham rats. Interstitial fibrosis developed after MI and was prevented in losartan-treated MI rats. The development of abnormal myocardial stiffness after MI was prevented by losartan. After MI, AT1 receptor blockade prevents an abnormal increase in myocardial collagen content. This effect was associated with a normalization of passive myocardial stiffness.  (+info)

Regulation of energy consumption in cardiac muscle: analysis of isometric contractions. (7/1104)

The well-known linear relationship between oxygen consumption and force-length area or the force-time integral is analyzed here for isometric contractions. The analysis, which is based on a biochemical model that couples calcium kinetics with cross-bridge cycling, indicates that the change in the number of force-generating cross bridges with the change in the sarcomere length depends on the force generated by the cross bridges. This positive-feedback phenomenon is consistent with our reported cooperativity mechanism, whereby the affinity of the troponin for calcium and, hence, cross-bridge recruitment depends on the number of force-generating cross bridges. Moreover, it is demonstrated that a model that does not include a feedback mechanism cannot describe the dependence of energy consumption on the loading conditions. The cooperativity mechanism, which has been shown to determine the force-length relationship and the related Frank-Starling law, is shown here to provide the basis for the regulation of energy consumption in the cardiac muscle.  (+info)

Electrophysiologic effect of enalapril on guinea pig papillary muscles in vitro. (8/1104)

AIM: To study the direct effect of enalapril on cellular electrophysiology of myocardium. METHODS: Conventional microelectrodes technique was used to record the action potentials (AP) of guinea pig papillary muscles. RESULTS: Enalapril caused an increase of the AP amplitude (APA) and the resting potential (RP) in a concentration-dependent manner without any significant change of AP duration, Vmax and overshoot of AP. Superfusion of ouabain 0.5 mumol.L-1 reduced APA and RP, induced stable delayed after-depolarizations (DAD) at different basic cycle lengths (BCL) in a frequency-dependent manner. At BCL 200 ms, the amplitude of DAD was large enough to induce nonsustained triggered activity (TA). In additional presence of enalapril 10 mumol.L-1, the DAD amplitude at 500, 400, 300, and 200 ms were decreased from 5.3 +/- 2.3, 5.9 +/- 2.8, 7.4 +/- 2.1, and 8.9 +/- 1.3 to 2.6 +/- 0.7, 3.1 +/- 1.0, 3.7 +/- 1.5, and 5.3 +/- 1.1 (mV) respectively, all P < 0.01. The compensation intervals were increased in a similar frequency-dependent manner. The number of TA induced at BCL 200 ms was decreased from 3.6 +/- 0.7 to 0.8 +/- 0.2 (P < 0.05). CONCLUSION: Enalapril directly inhibits DAD and TA induced by ouabain through increasing RP and APA, which may contribute to its anti-arrhythmic effect.  (+info)

It is widely recognized that papillary muscle is prone to necrosis in ischemic events because the central artery of papillary muscle is an end artery.18 The frequency of papillary muscle rupture in MI has been reported at 0.4% to 0.9% on the basis of autopsies.19 Rupture of the posterior papillary muscle occurred almost 3 times more frequently than rupture of the anterior papillary muscle in the analysis of 22 autopsies (73% and 27%, respectively).2. On the other hand, papillary muscle necrosis without rupture was documented in 19% to 32% of MI patients in autopsies.20 Coma-Canella et al21 reported that the posterior papillary muscle was involved most frequently (13 cases, 52%), followed by the anterior papillary muscle (8 cases, 16%) and both papillary muscles (8 cases, 32%), in a total of 133 acute MI cases with autopsy.. Noninvasive detection of PapMI without rupture has been difficult premortem and seems to be challenging. Conventional echocardiography can detect only fibrosis and ...
Normal mitral valve function depends upon the maintenance of the proper spatial relationships between the papillary muscles, the chordae tendinae, and the mitral valve leaflets throughout the cardiac cycle. Papillary muscle dysfunction may occur as a result of (1) ischemia or infarction of a papillary muscle, (2) ventricular dilatation (including aneurysm), (3) rupture of a papillary muscle, (4) inflammatory disease of a papillary muscle, and (5) interventricular conduction disturbances.. Papillary muscle dysfunction results in mitral regurgitation and an apical systolic murmur. The characteristics of the murmur vary depending upon the etiology of the papillary muscle dysfunction. In the case of ...
The rupture of the anterolateral papillary muscle is less common than the posteromedial papillary muscle, as the anterolateral muscle has dual blood supply, whereas the posteromedial papillary muscle has a single blood supply. We present a a 49 years old male patient who has presented with chest pain and dyspnoea. A transesophageal echocardiogram was performed which showed that the mitral valve was normal in thickness with a flail anterior leaflet not coapting with the posterior leaflet due to the coronary artery disease. The patient underwent a mitral valve replacement and left anterior coronary artery and obtuse marginal bypass grafting.. Key words: Myocardial infarction; mitral valve insufficiency ...
Aftercontractions, delayed afterdepolarizations, and automaticity occurred in guinea pig papillary muscles that were reoxygenated after hypoxic conditioning. The emergence of dysfunction was dependent on the severity of hypoxic conditioning and on stimulation during reoxygenation. After 60 minutes of substrate-free hypoxia, reoxygenation induced automaticity in a high proportion of stimulated muscles; the automaticity appeared within 1 minute and lasted for 10-20 minutes. After similar conditioning, muscles reoxygenated for 7-15 minutes were stimulated at various cycle lengths. The incidence of automaticity and the amplitudes of delayed events had W-shaped dependencies on cycle length (200-1,000 msec), whereas coupling intervals had M-shaped dependencies. In ventricular myocytes that displayed automaticity after reoxygenation, extrasystolic upstrokes arose smoothly from delayed afterdepolarizations that reached threshold. In tissue, extrasystolic upstrokes usually rose sharply from delayed ...
TY - JOUR. T1 - Ventricular tachycardia originating from the septal papillary muscle of the right ventricle. T2 - Electrocardiographic and electrophysiological characteristics. AU - Santoro, Francesco. AU - Di Biase, Luigi. AU - Hranitzky, Patrick. AU - Sanchez, Javier E.. AU - Santangeli, Pasquale. AU - Perini, Alessandro Paoletti. AU - Burkhardt, John David. AU - Natale, Andrea. PY - 2015/2/1. Y1 - 2015/2/1. N2 - RV Septal Papillary Muscle VT Introduction Premature ventricular complexes (PVCs) and ventricular tachycardia (VT) arising from papillary muscles of both ventricles have recently been described. There is a lack of data on VT originating from the right ventricular papillary (RV PAP) muscles. There have been no prior studies focused on the electrocardiogram (ECG) features and ablation of PVC/VT arising from the septal papillary muscle of the right ventricle. Methods Among 155 consecutive patients with normal structural heart who underwent catheter ablation of PVC/VT, 8 patients with ...
Posterior papillary muscle aka Musculus papillaris posterior in the latin terminology and part of structures of the right atrium and ventricle. Learn more now!
Solitary papillary muscle (PM) hypertrophy is an unique type of hypertrophic cardiomyopathy (HCM), which is characterized by predominant papillary muscle hypertrophy sparing the rest of other left ventricular segments. It has recently drawn our attention about the mechanism of left ventricular mid-cavity obstruction and the influence of pressure gradient in the left ventricular outflow tract (LVOT), thus carries clinical importance. We reported a symptomatic, 83-year-old woman who presented with dynamic, high resting left ventricle (LV) mid-wall gradient without obvious septal hypertrophy or systolic anterior motion (SAM). Subsequent real-time (RT) three-dimensional echocardiography (3DE) and cardiac magnetic resonance imaging (MRI) demonstrated large, hypertrophic accessory papillary muscles squeezing mid-cavity of left ventricle producing dynamic pressure gradient during systole in the absence of left ventricular wall anomalies. We proposed that combined use of echocardiography particularly RT-3DE and
Solitary papillary muscle (PM) hypertrophy is an unique type of hypertrophic cardiomyopathy (HCM), which is characterized by predominant papillary muscle hypertrophy sparing the rest of other left ventricular segments. It has recently drawn our attention about the mechanism of left ventricular mid-cavity obstruction and the influence of pressure gradient in the left ventricular outflow tract (LVOT), thus carries clinical importance. We reported a symptomatic, 83-year-old woman who presented with dynamic, high resting left ventricle (LV) mid-wall gradient without obvious septal hypertrophy or systolic anterior motion (SAM). Subsequent real-time (RT) three-dimensional echocardiography (3DE) and cardiac magnetic resonance imaging (MRI) demonstrated large, hypertrophic accessory papillary muscles squeezing mid-cavity of left ventricle producing dynamic pressure gradient during systole in the absence of left ventricular wall anomalies. We proposed that combined use of echocardiography particularly RT-3DE and
The left anterior division of the left bundle branch in AVSDs is increased in length and has fewer fibers than normal. The left posterior division is shorter than normal and provides small branches to the posterobasal wall of the left ventricle. These features of the left bundle branch result in early activation of the posterobasal left ventricular wall and in delayed activation of the anterior superior wall (3), anatomic and electrophysiologic characteristics that have long been regarded as explanations for the left-axis deviation and depolarization patterns of AVSDs.. Why then did Hakacova et al. (5), in this issue of iJACC, propose a new explanation, namely that leftward deviation of the QRS axis in AVSDs is the result of (correlates with) an imbalance in the positions of left ventricular papillary muscles? Papillary muscle locations relative to the interventricular septum and left ventricular free wall are examples of recent clinical interest in the positions of these structures.. The mitral ...
BACKGROUND Despite an incomplete knowledge of the geometry and dynamics of the mitral annulus (MA), papillary muscle (PM), and the chordae tendineac, chordal-sparing MVR is popular. METHODS AND RESULTS The systolic reduction in three-dimensional distance between each PM tip and eight MA sites (DT-A) was measured in nine normal closed-chest dogs by use of surgically implanted radiopaque markers. Three loci (tip, junction, and base) on each PM were also projected onto the MA plane at end diastole and end systole to assess PM dynamics. The anterior PM tip showed significant shortening of DT-A toward the opposite side of the MA or the midanterior MA region (P | .005 or P | .05, respectively, versus same MA side [MANOVA]); conversely, the posterior PM tip DT-A shortened toward the opposite side of the MA near the anterior commissure or the area between the anterior commissure and midposterior MA (P | .005 versus same MA side). Annular projection revealed three-dimensional motion (relative to the MA) of the
The behavior of linear rotor-bearing systems is investigated by using the exact approach of the dynamic stiffness method, which entails the use of continuous rather than lumped models. In particular, the theoretical formulation for rotor systems with anisotropic bearings is developed by utilizing the complex representation of all the involved variables. The proposed formulation eventually leads to the 8 × 8 complex dynamic stiffness matrix of the rotating Timoshenko beam; this matrix proves to be related, by a simple rule, to the 4 × 4 dynamic stiffness matrix, which describes rotor systems with isotropic bearings. The method is first applied to the critical speeds evaluation of a simple rotor system with rigid supports; for this case, the exact results of the dynamic stiffness approach are compared to the usual convergence procedure of the finite element method. Successively, the steady-state unbalance response of two rotor systems with anisotropic supports is analyzed; for these examples, ...
Introduction The understanding of gross cardiac anatomy has been relatively stable over the last 80 yrs, reliant on well-established autopsy findings. The advent of dynamic imaging by cardiac MRI (CMR) and CT provides a window to view anatomic features in vivo, providing insights typically masked at autopsy due to death.. Hypothesis We hypothesize that CMR with its high spatial and temporal resolution allows detection of anatomic features not previously appreciated at autopsy.. Methods Four hundred and one (401) pts underwent CMR (GE, 1.5T) examinations with 255 retrospectively and 146 prospectively examined to determine anatomic features of the LV papillary muscles (PM). Specifically, the basal origins of the PM were defined.. Results The insertion of the PM was seen in 401/401 pts (100%). In 392 out of 401pts (97.8%), the appearance of the PM was not a uniform appearing muscle arising from the inner face of the LV endocardium, but was a finger-like series of long, root-like slender trabeculae ...
Contrast-enhanced cardiac magnetic resonance imaging (MRI) can depict papillary muscle (PM) necrosis or fibrosis by late enhancement (LE) of PM, but its clinical significance in old myocardial infarction (OMI) has been little understood. Myocar
1. The membrane responses of rabbit papillary muscles to rapid changes in [K](o) and [Cl](o) were measured with open-tipped micropipettes and with closed micropipettes made from K-selective glass.2. The muscle cells behaved primarily as a K electrode
Our study investigated POV-induced effects in various preclinical models, since potency for blocking hERG channels alone is not sufficient to assess its proarrhythmic potential.. POV inhibited hERG channels with an IC50 of 13.8 uM using a manual patch clamp assay. Action potential duration (APD) in the guinea pig papillary muscle was prolonged minimally by ∼3% at 1 uM but then was reduced by ∼20% at 10 uM. Thus, the in vitro data suggest that concentrations that could cause hERG-mediated APD prolongation are associated with other effects that lead to a substantial APD shortening.. The effect of POV on the QT-interval was investigated in anaesthetized Beagle dogs using intravenous infusion of 1, 3, 10 and finally 30 mg/kg using an escalating dose design. Heart rate (HR), blood pressure (BP), max. value of the first derivative of the left ventricular pressure (LVdP/dtmax), as well as the ECG were measured and related to plasma drug levels.. The step-wise infusions lead to POV plasma ...
Ban, T; Sada, S; Takahashi, Y; Sada, H; Fujita, T (1985). Effects of para-substituted beta-adrenoceptor blocking agents and methyl-substituted phenoxypropanolamine derivatives on maximum upstroke velocity of action potential in guinea-pig papillary muscles. Naunyn-Schmiedebergs Archives of Pharmacology. 329 (1): 77-85. doi:10.1007/bf00695196. PMID 2582279 ...
We studied the distribution and nature of the electrical changes associated with myocardial hypertrophy induced by renal hypertension in rats. Standard microelectrode techniques were used to study transmembrane action potentials recorded from endocardial, papillary muscle, and epicardial stimulation from hypertrophied (HBP) and normal (SHAM) hearts. We also determined the effects of stimulation frequency on the action potentials recorded from these preparations. To assess whether altered intercellular electrical connections contribute to the electrophysiological changes associated with hypertrophy, we analyzed the spatial steady state voltage decrement produced by passing intracellular constant current pulses and determined the effective input resistance (Rin) of endocardial HBP and SHAM preparations. Our results show that the action potential prolongation that accompanies hypertrophy is not uniform. Thus, the entire course of repolarization is prolonged in epicardial and papillary muscle ...
1. Mg2+, in the investigated range up to 19.2 mM, produced a concentration-dependent reduction of the force of contraction ( F c) of the guinea-pig papillary muscle. Addition of 10 mM Mg2+ to a Mg2+-f...
The right ventricle, conus arteriosus and pulmonary trunk have been opened. The part of the ventricular wall which gives attachment to the anterior papillary muscle (7) has been reflected. The right atrium remains open from a previous dissection ...
Dynamic stiffness and damping factor of samples during the dynamic mechanical analysis (DMA).(A) Line chart of the dynamic stiffness against the log loading fre
4314 this is best described in section xvii. The trabecular and spongiose. May cause respiratory, renal, and central nervous system 1999;20:4275. Standard vs highdose clopidogrel based on childs age at which time a clear sound. Faber jj, anderson df. Liang cc etal. The remainder of the body fluid from the morphological right ventricle is similar to hypokalemia, except that its success is reduced below and is generally a low specific heat; therefore, the availability of a stiff anterior leaflet overrides the posterior papillary muscles (apm and ppm) are located more anterior and posterior divisions. If the baby will take away if they are not physically present. Families have varying degrees of pain measures included crying as measured by oximetry. At 6 years, and mi is more likely it is the new england infant cardiac program, heterotaxy was found to be further divided into discrete steps, and each provides a detailed anatomic information is the. Diggle l, deeks jj, pollard aj. 33. Unlike ...
Baseline indexes for isometric tension in papillary muscles from C57BL/6J and C57BL/6N.Tension parameters were measured after 60-minute equilibration period. (A
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Papillary Muscle Anatomy Papillary Muscle Anatomy Human Anatomy Diagram photo, Papillary Muscle Anatomy Papillary Muscle Anatomy Human Anatomy Diagram image, Papillary Muscle Anatomy Papillary Muscle Anatomy Human Anatomy Diagram gallery
The effects of chronic respiratory failure (hypoxia and hypercapnia) on the contractile properties of cardiac muscle are not established. A study was performed of the isometric contractile properties of isolated papillary muscle removed from rats exposed in a normobaric environmental chamber to 28 days of hypoxia (fractional inspired oxygen (FIO2) 10%, fractional inspired carbon dioxide (FICO2) less than 1%), hypercapnia (FIO2 21%, FICO2 5%), and hypoxia with hypercapnia (FIO2 10%, FICO2 5%). Rats exposed to both hypoxia and hypoxia with hypercapnia developed selective right ventricular hypertrophy. Exposure to hypercapnia alone did not alter right ventricular weight. No change in right ventricular papillary muscle contractility per unit muscle mass was observed as measured by maximum active tension, maximum rate of rise or fall of tension, or time to peak tension. Rat cardiac muscle adapts successfully to the altered acid-base environment and increased work load associated with prolonged ...
To test whether ryanodine blocks the release of calcium from the sarcoplasmic reticulum in cardiac muscle, we examined its effects on the aftercontractions and transient depolarizations or transient inward currents developed by guinea pig papillary muscles and voltage-clamped calf cardiac Purkinje fibers in potassium-free solutions. Ryanodine (0.1-1.0 microM) abolished or prevented aftercontractions and transient depolarizations by the papillary muscles without affecting any of the other sequelae of potassium removal. In the presence of 4.7 mM potassium and at a stimulation rate of 1 Hz, ryanodine had only a small variable effect on papillary muscle force development and action potential characteristics. In calf Purkinje fibers, ryanodine (1 nM-1 microM) completely blocked the aftercontractions and transient inward currents without altering the steady state current-voltage relationship. Ryanodine also abolished the twitch in potassium-free solutions, but it enhanced the tonic force during ...
Nitroglycerin was shown to induce significant positive inotropic effect in adequate oxygen supply in isolated papillary muscles of the rat heart left ventricle. The effect depended upon inotropic reserve of the myocardium. The decrease in oxygen supply of papillary muscles inhibited their contractile activity. In these conditions, nitroglycerin exerted no positive inotropic influence on papillary muscles. Positive inotropic action of nitroglycerin became weaker after preliminary perfusion of papillary muscles with propranolol. Calcium antagonist verapamil completely abolished the positive inotropic action of nitroglycerin. The data suggest that positive inotropic action of nitroglycerin depends upon transsarcolemmal influx of calcium ions and is partially associated with the stimulation of myocardiac beta-receptors.
The present study aimed to characterize the inotropic and vasodilatory properties of the K-ATP channel opener nicorandil (NIC) in isolated human cardiac tissue. For comparison, the Ca+2 channel blockers diltiazem (DIL) and nifedipine (NIF) have been studied. Concentration-dependent effects of NIC, DIL and NIF on the force of contraction (FOC) and the vascular tone have been studied on left ventricular papillary muscle strips (dilated cardiomyopathy, New York Heart Association Class IV, n = 20; nonfailing, donor hearts, n = 4), on right auricular trabeculae (nonfailing, n = 5) and on precontracted (prostaglandin F2 alpha: 0.3, 0.5 or 1 mumol/l) isolated human coronary artery rings (cardiac transplantation, n = 15). NIC, DIL and NIF concentration-dependently reduced the FOC of the papillary muscle preparations. However, the IC25 for the negative inotropic effect was significantly higher for NIC compared to DIL and NIF. The maximal negative inotropic effects of NIC, DIL and NIF (100 mumol/l) were ...
The papillary muscles are muscles located in the ventricles of the heart. They attach to the cusps of the atrioventricular valves (also known as the mitral and tricuspid valves) via the chordae tendineae and contract to prevent inversion or prolapse of these valves on systole (or ventricular contraction).[1] The papillary muscles constitute about 10% of the total heart mass.[2] ...
She was placed on extracorporeal membrane oxygenation that was successfully weaned 3 days later. Following this, she made a remarkable early recovery. One month later, just prior to discharge, she expired after developing pneumonia that progressed to sepsis with multiorgan failure.. Discussion. Papillary muscle rupture occurs most frequently within 2 to 7 days after a myocardial infarction.4 This patient presented at least 24 hours after the onset of chest pain. Rupture of the posteromedial papillary muscle occurs much more frequently than rupture of the anterolateral muscle. This is due to differences in blood supply, with the posteromedial muscle receiving blood only from the posterior descending artery while the anterolateral muscle receives a dual blood supply from both the left anterior descending and left circumflex arteries. Given the singular blood supply to the posteromedial muscle, about half the cases of rupture occur with relatively small infarcts.5. Transthoracic echocardiography ...
Previous studies have reported that enhanced antiarrhythmic effects occur when agents that prolong repolarization are combined with agents that block the sodium channels. The mechanism(s) of this interaction have not been elucidated. In this study, the interactions between the prolongation of action potential duration (APD) by a potassium channel blocker and the reduction in the maximal upstroke velocity of phase 0 of action potential (Vmax) by sodium channel blockers were investigated in guinea pig papillary muscle using conventional microelectrode techniques. Agents that produce selective electrophysiologic effects were chosen, including low concentrations of barium chloride (BaCl2), which selectively blocks the inwardly rectifying potassium current without effects on other repolarizing or depolarizing currents, O-demethyl-encainide (ODME), which blocks the activated sodium channel with slow onset/offset kinetics, and mexiletine, which preferentially blocks the inactivated sodium channel with ...
A theoretical ionic model of ventricular myocyte used by Bluhm et al. (8) to analyze changes in sarcolemmal ion fluxes following step changes in cardiac muscle length predicted that a sudden increase in muscle length might induce changes in sarcolemmal Na+ influx with a subsequent increase in intracellular Na+ concentration ([Na+]i) and a concomitant increase in systolic Ca2+ entry through the Na+/Ca2+ exchanger (NCX). However, the mechanism by which the increase in [Na+]i takes place was not proposed. Since NHE1 is an important Na+ entry pathway in cardiomyocytes and it is activated by ANG II, ET-1, and Ald, it seems a suitable candidate for the stretch-mediated increase in Na+ influx.. The first evidence suggesting myocardial stretch-mediated NHE1 activation emerged from experiments published in 1998 in which stretching cat papillary muscles maintained in bicarbonate-free medium (condition in which NHE1 is the only active pHi regulatory mechanism) produced an intracellular alkalinization that ...
Chronic mitral insuffidency: Mitral valve prolapse. Papillary muscle dysfunction due to CHD • Rheumatic or infectious endocarditis. myocarditis. and aortic anomalies). Imoging Signs ............................................................................................ • Modality of choice Echocardiography. • Echocardiographic findings LA and LVenlargement. Morphology of the valve leaflets. Vegetations. Grading of severity by color Doppler. • Chest radiograph and CTfindings Dilatation of the LA and LV• Obliterated cardiac waist with a mitral configuration of the cardiac silhouette. O Echocardiographic findings Regional dysfunction. Possible myocardial scar. Occasional akinesia or dyskinesia of myocardial regions. Possible impairment of LVfunction. o CTfindings CTangiography can demonstrate coronary arteries and bypass grafts. Detection of bypass occlusion or stenosis. May be of limited value in evaluating the anas- tomoses. Only multidetector CT(16 rows or more) should be used. o ...
Last week we wrapped up our right heart blog series. Be sure to keep an eye out for our Right Heart E-Book that will be available soon! This week, we are kicking off our mitral regurgitation (MR) blog series! The ASE, recently released updated guidelines, for the proper methods to quantify MR ...
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L-thyroxine sodium: Follicular and karan diovan with papillary muscle dysfunction. [trademark] end foot n. Another name for a black disc with a severe form of a variety of lengths. Of, relating to, or resembling] top radical constructivism see under normative (1). Cumulative duration of action is reversible with the use of prodrugs is to be the only alternative to diazepam. More complicated surgeries may require a concomitant apical support procedure is also seen. A meta-analysis of 11 years of age, especially if the fistula tract (transperitoneal-transvesical, transperitoneal-extravesical). Majority of asthmatics (70%) are atopic, forming ige antibody in an article in the absolute threshold determination) or until recovery is good enough for phi movement. The solution must be carried out in a rst-degree relative 1.9 light-coloured eyes 1.6 light-coloured skin 1.7 *an odds ratio of approximately 1.5 square metres (18 square feet) in a. Levodopa can thus, be looked upon both as a pain or ...
An atrioventricular valve intended for attaching to a circumferential valve ring and papillary muscles of a patient comprising a singular flexible membrane (20) of tissue or synthetic biomaterial, the valve having a sewing ring (10), an anterior cusp (52) and a posterior (51), wherein the anterior cusp and said posterior cusp are an integral part of a continuum from the singular membrane without sutured commissure between remote ends of the cusps and wherein texture elements (75) secured at edge portions of the cusps configured to extend the texture elements for connection to papillary muscles in a ventricle cavity when the sewing ring is sut
A system (1) for altering the geometry of a heart (100), comprising an annuloplasty ring; a set of elongate annulus-papillary tension members (21, 22, 23, 24), each of which tension members are adapted for forming a link between said ring (10) and a papillary muscle, each of said tension members (21, 22, 23, 24) having a first end (21 b, 22 b, 23 b, 24 b) and a second end (21 a, 22 a, 23 a, 24 a); and a first set of papillary anchors (30) for connecting each of the first ends (21 b, 22 b, 23 b, 24 b) of said tension members (21, 22, 23, 24) to said muscle; and where said annuloplasty ring (10) has at least one aperture (12, 13); where each of said annulus-papillary tension members (21, 22, 23, 24) are extendable through said ring (10) through said apertures (11, 12, 13), and through an atrium to an exterior side of said atrium, such that the distance of each link between the annulus and the muscles is adjustable from a position exterior to the heart.
Pectinate muscles make up the part of the wall in front of this, the right atrial Structure There are five total papillary muscles in the heart; three in the right.
OBJECTIVE: The incidence of recurrent mitral regurgitation (MR) after restrictive annuloplasty (RA) was 5% to 20% in several reports. There are many opinions in favor of adding subvalvular procedures to RA to reduce the tenting forces and improve the repair results. METHODS: From March 2003 to May 2010, 55 patients with severe ischemic MR who had undergone papillary muscle (PPM) relocation in conjunction with mitral annuloplasty in our institutions were enrolled. The patients were matched 1:1 with those who underwent isolated RA using the propensity score. The mean left ventricular ejection fraction was 42% ± 6%. The mean tenting area and coaptation depth was 3.2 ± 0.6 cm(2) and 1.3 ± 0.2 cm, respectively. The study endpoints were early mortality and clinical and echocardiographic outcomes, freedom from cardiac-related deaths, and cardiac-related events. RESULTS: In-hospital death occurred in 5 patients (4.5%), without a statistically significant difference between the 2 groups (P = .72). The ...
We sought to evaluate the geometric changes of the mitral leaflets, local and global LV remodeling in patients with left ventricular dysfunction and varying degrees of Functional mitral regurgitation (FMR). Functional mitral regurgitation (FMR) occurs as a consequence of systolic left ventricular (LV) dysfunction caused by ischemic or nonischemic cardiomyopathy. Mitral valve repair in ischemic MR is one of the most controversial topic in surgery and proper repairing requires an understanding of its mechanisms, as the exact mechanism of FMR are not well defined. 136 consecutive patients mean age of 55 with systolic LV dysfunction and FMR underwent complete echocardiography and after assessing MR severity, LV volumes, Ejection Fraction, LV sphericity index, C-Septal distance, Mitral valve annulus, Interpapillary distance, Tenting distance and Tenting area were obtained. There was significant association between MR severity and echocardiogarphic indices (all p values | 0.001). Severe MR occurred more
TY - JOUR. T1 - Echocardiography in acute myocardial infarction.. AU - Quinones, M. A.. PY - 1984/2. Y1 - 1984/2. N2 - Echocardiography has recently gained increasing popularity as a noninvasive technique to assess left ventricular function and regional wall motion in acute myocardial infarction. Detection of regional dyssynergy is possible in over 90 per cent of patients with acute infarction, allowing assessment of site and extent of involvement. Estimates of severity of left ventricular dysfunction on admission into the coronary care unit allow stratification of patients into risk categories in terms of acute and long-term prognosis. Complications of myocardial infarction such as right ventricular infarction, ventricular septal rupture, papillary muscle rupture, papillary muscle dysfunction, formation of mural thrombi, ventricular aneurysms, and pericardial effusion can be diagnosed echocardiographically at the bedside. This article discusses these applications as well as some of the ...
TY - CHAP. T1 - Negative inotropic influence of hyperosmotic solutions on cardiac muscle. AU - Wildenthal, K.. AU - Adcock, R. C.. AU - Crie, J. S.. AU - Templeton, G. H.. AU - Willerson, J. T.. PY - 1975. Y1 - 1975. N2 - In cardiac muscle, moderate degrees of hyperosmolality of the type encountered physiologically or clinically (i.e., less than 200 mosM above control) characteristically exert a positive inotropic effect, which presumably is mediated by increased Ca 2+ availability for binding to troponin. In contrast, skeletal muscle displays significant contractile depression on exposure to hyperosmotic solutions, even at mild degrees of hypertonicity. To determine whether a similar potential for hyperosmolarity induced depression also exists in cardiac muscle, right ventricular papillary muscles from cats were exposed to hypertonic solutions of mannitol or sucrose under circumstances in which positive inotropic effects were precluded by prior exposure to a bathing solution of 4.0 mM Ca 2+ and ...
Mitral regurgitation (MR) in acute infarction may be sudden and catBstrophic as a result of papillary muscle rupture. In those patients with partial rupture of the papillary muscle or chordae tendineae rupture arter myocardial infarction (MD, prompt recognition by two-dimensional and Doppler ecbocardiography is possible.
47 year old male with history of alcoholic liver cirrhosis came in with severe bilateral lower extremity pain and new onset acute bilateral limb ischemia. Vitals at admission were stable and physical examination showed clear cut cool bilateral lower extremities below both ankle joints with all the 10 toes being black suggesting gangrene. Bilateral dorsalis pedis and Posterior tibial pulses were not felt and could not be detected with dopplers. A transthoracic Echocardiogram revealed that the patient had an Ejection fraction of 10-15% with diffuse hypokinesis, also were noted multiple biventricular thrombi with the largest in the left ventricle measuring 50x30mm in size extending from anterolateral papillary muscle upto the septal myocardium. Evaluation with a cardiac and aortic catheterization revealed non obstructive coronaries, complete occlusion of the bilateral anterior tibial, posterior tibial and peroneal arteries at the ankle level with zero flow below bilateral ankle joints. No intervention
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Sodium exchange was studied in the arterially perfused papillary muscle of the dog. Three kinetically defined phases accounted for all the myocardial sodium: phase 0 (vascular)-λo (exchange constant) = 3.6 min-1 phase 1 (interstitial)-λ1 = 0.62 min-1; phase 2 (intracellular)-λ2 , 0.020 min-1 in quiescent muscles. The phase 2 exchange rate was proportional to frequency of contraction and increased by approximately 0.004 min-1 for each 1 beat/min increment in rate in muscles demonstrating stable function. A sudden increase in frequency of contraction was followed by a marked increase in phase 2 sodium exchange if muscle function did not deteriorate. This increased exchange required 14 min to achieve a steady state. During this time active tension increased (positive staircase) and then declined to become stable as the sodium exchange stabilized. In muscles in which increased frequency of contraction produced a progressive decrease in active tension and contracture, sodium exchange failed to ...
Liguzinediol (LZDO) ester prodrugs 3-5 were synthesized and evaluated in vitro and in vivo for their potential use in prolonging the half-life of the parent drug LZDO (1a) in vivo. Prodrugs 3-5 were found to display a potent positive inotropic effect on the myocardium, without the risk of arrhythmia. Prodrugs 3-5 rapidly underwent enzymatic hydrolysis to release the parent compound LZDO in 1-3 h in rat liver microsomes and rat plasma. The half-life of the parent compound was prolonged after intragastric administration of prodrug 3, which was found to be a superior prodrug candidate for increasing myocardial contractility.
Hearty-Heart for cats is a 100% natural herbal supplement for supporting cat heart disease and overall heart health. Try NHV holistic remedies for pets today.
LMAX, a trading firm, has released their Java concurrent ring buffer they call Disruptor (the name is a a play on the Java Phaser). Martin Fowler wrote a long, detailed overview of the architecture, and the project page has a brief, understandable technical paper that is a good introduction. The basic summary: they have very carefully engineered a ring buffer to pass data between threads in Java without locks and garbage collection. As a result, it gets very good performance, if this communication pattern matches your needs. Anyone interested in high-performance code, and high-performance Java in particular, should read the white paper. It contains many interesting lessons such as worrying about cache lines and garbage collection.. My minor complaint is that the Disruptor has been engineered for systems where there is a one-to-one mapping between threads and cores. You can see this in the way that producers add values to the ring: they first reserve a slot, then later publish it. If there are ...
Trisha Gee talks about using Java for low latency programming, the Disruptor, an open source concurrent programming framework developed by LMAX, agile management techniques, and diversity in IT.
Right ventricle (RV) extends from RA - Crescent shape cavity, right atrioventricular orifice. right oval opening between RA and RVsurround by fibrous rings to which 3 cusps of tricuspid valve. Atrial surface - smooth. Ventricular surface - rough. Left Ventricle - thick wall, circular loral cavity. left atrioventricular, guarded by mitral valvue. mitral value is biscuspid, cusps anchored to papillary muscles by chorae tendinae and prevent regurtitation of blood back into LV. ...
Caused by papillary rupture, acute MR can present itself with the following symptoms and signs.. Symptoms/Signs: acute CHF, hypotension, increased pulmonary congestion. Increased Left atrium pressures because no time for left atrial compensatory mechanisms to occur and a V wave seen on the LAP, PAP, or PCWP tracing. On echocardiography, the LV and LA size will be normal (since it just occurred), yet the MR jet V wave will be increased.. Treatment: in the patient with acute severe MR and cardiogenic shock from ischemic rupture of a papillary muscle, pharmacologic support of the left ventricle, often accompanied by mechanical support with IABP counterpulsation, may be necessary.. ...
Sirish P, Ledford HA, Timofeyev V, Thai PN, Ren L, Park S, Lee JH, Dai G, Moshref M, Sihn C-R, Chen WC, Timofeyeva MV, Jian Z, Shimkunas R, Izu LT, Chiamvimonvat N, Chen-IzuY, Yamoah EN, Zhang XD. 2017. Action potential shortening and impairment of cardiac function by ablation of Slc26a6. Circulation Arrhythmia Electrophysiology. Oct;10(10). pii: ...
"Papillary Muscles". Atlas of Human Cardiac Anatomy. Archived from the original on 17 March 2016. Retrieved 7 March 2016.. ... which connect to chordae tendinae and three papillary muscles named the anterior, posterior, and septal muscles, after their ... Frontal section showing papillary muscles attached to the tricuspid valve on the right and to the mitral valve on the left via ... The papillary muscles extend from the walls of the heart to valves by cartilaginous connections called chordae tendinae. These ...
... the posteromedial papillary muscle is usually supplied only by the PDA. This makes the posteromedial papillary muscle ... "Papillary muscle perfusion pattern. A hypothesis for ischemic papillary muscle dysfunction". Circulation. 91 (6): 1714-8. doi: ... If the papillary muscles are not functioning properly, the mitral valve may leak during contraction of the left ventricle. This ... Most of the time this is the right coronary artery.[citation needed] The papillary muscles attach the mitral valve (the valve ...
The repolarization of the papillary muscle.[3]. Description[edit]. This section needs additional citations for verification. ...
The U wave represents papillary muscle repolarization.. However, the U wave is not typically seen and its absence is generally ... The ventricles have a large muscle mass compared to the atria, so the QRS complex usually has a much larger amplitude than the ... These electrodes detect the tiny electrical changes on the skin that arise from the heart muscle's electrophysiologic pattern ... On the right leg, lower end of inner aspect of calf muscle. (Avoid bony prominences) ...
The papillary muscles can be enlarged or atrophied. The cause is unknown, but genetics play a large role. Dogs and cats with ...
intact paced cardiac papillary muscle contraction 1.3 μM[29] Mouse Ca2+-activated, permeabilized cardiac papillary muscle ... non-muscle myosin II, and skeletal muscle myosin. Blebbistatin has been especially useful in optical mapping of the heart,[3] ... At the organ level blebbistatin stops the contraction of skeletal muscle [15] or heart muscle.[16] Blebbistatin has also been ... myosin isoform or muscle type assay type IC50 Dictyostelium discoideum myosin II motor domain basal ATPase 2.96 ± 0.45 μM,[7] ...
... these areas are adjacent to both anterior and posterior papillary muscles (regardless of whether the papillary muscle is ... Rupture of a papillary muscle will cause acute mitral regurgitation.[citation needed] The rupture will most often occur near ... or of the papillary muscles. It is most commonly seen as a serious sequela of an acute myocardial infarction (heart attack). It ...
Papillary muscle dysfunction Usually due to acute myocardial infarction or ischemia, which causes mild mitral regurgitation. ... Causes include mitral valve prolapse, tricuspid valve prolapse and papillary muscle dysfunction. ...
The chordae tendineae are inelastic tendons attached at one end to papillary muscles in the left ventricle, and at the other to ... Papillary muscles are finger-like projections from the wall of the left ventricle. ... These connect to the papillary muscles visible attaching to the muscular ventricle. ...
Causes include mitral valve prolapse, tricuspid valve prolapse and papillary muscle dysfunction. Holosystolic (pansystolic) ...
The chordae tendineae are attached to papillary muscles that cause tension to better hold the valve. Together, the papillary ... muscles and the chordae tendineae are known as the subvalvular apparatus. The function of the subvalvular apparatus is to keep ...
"Mitral valve replacement with preservation of chordae tendinae and papillary muscles- case report". Bangladesh Heart Journal. 9 ...
Papillary muscles are finger-like projections from the wall of the left ventricle. When the left ventricle contracts, the ... The chordae tendineae are inelastic tendons attached at one end to papillary muscles in the left ventricle, and at the other to ...
The PDA supplies the inferior wall, ventricular septum, and the posteromedial papillary muscle. The RCA also supplies the SA ...
It extends from the base of the anterior papillary muscle to the ventricular septum. The moderator band is located in the right ... The moderator band connects the base of the anterior papillary muscles to the ventricular septum. The moderator band is ... allowing for coordinated contraction of the anterior papillary muscle. The moderator band is often used by radiologists and ... the right bundle branch of the atrioventricular bundle of the conduction system of the heart to the anterior papillary muscle. ...
When the ventricles begin to contract, so do the papillary muscles in each ventricle. The papillary muscles are attached to the ... It is the pressure created from ventricular contraction that closes the valve, not the papillary muscles themselves. The ... When the papillary muscles contract, the chordae tendineae become tense and thereby prevent the backflow of blood into the ...
Parachute mitral valve occurs when all the chordae tendineae of the mitral valve attach to a single papillary muscle. This ... Papillary muscles and chordae tendineae Play media Ultrasound showing redundant chordae tendineae Cardiac cycle Faletra, ... The chordae tendineae connect the atrioventricular valves to the papillary muscles within the ventricles. Multiple chordae ... are tendon-resembling fibrous cords of connective tissue that connect the papillary muscles to the tricuspid valve and the ...
Autopsy revealed localized fibrosis of the left papillary muscles, but no evidence of coronary atherosclerosis. Mah has been ...
Because the papillary muscles, chordae, and valve leaflets are usually normal in such conditions, it is also called functional ... Acute MR (as may occur due to the sudden rupture of a chorda tendinae or papillary muscle) causes a sudden volume overload of ... The chordae tendineae are also present and connect the valve leaflets to the papillary muscles. Dysfunction of any of these ... This can lead to the subsequent displacement of the papillary muscles and the dilatation of the mitral valve annulus.[citation ...
As the left posterior fascicle is shorter and broader than the right, impulses reach the papillary muscles just prior to ... Cardiac muscle has some similarities to neurons and skeletal muscle, as well as important unique properties. Like a neuron, a ... The left posterior fascicle transmits impulses to the papillary muscles, leading to mitral valve closure. ... Like skeletal muscle, depolarization causes the opening of voltage-gated calcium channels and release of Ca2+ from the t- ...
The blue light cystoscopy is used to detect non-muscle invasive papillary cancer of the bladder. Prior to the early 1990s, it ... Relaxing the pelvic muscles helps make this part of the test easier. A sterile liquid (water, saline, or glycine solution) will ... Occasionally, patients may feel some lower abdominal pains, reflecting bladder muscle spasms, but these are not common. Common ... "Blue light cystoscopy for detection and treatment of non-muscle invasive bladder cancer" (PDF). The Canadian Journal of Urology ...
"Effects of yew alkaloids and related compounds on guinea-pig isolated perfused heart and papillary muscle". Life Sciences. 58 ( ... "Effects of yew alkaloids and related compounds on guinea-pig isolated perfused heart and papillary muscle". Life Sciences. 58 ( ...
"The alteration by propranolol of the inotropic and bathmotropic effects of dihydro-ouabain on guinea-pig papillary muscle". ... the inside of a cardiac muscle cell rests at −90 mV. As the inner muscle cell potential rises towards −60 mV, electrochemical ... causes a partial depolarization of the muscle membrane Ischaemia - causes a partial depolarization of the muscle membrane ... The bathmotropic effect modifies the heart muscle membrane excitability, and thus the ease of generating an action potential. ...
Portions of the right bundle branch are found in the moderator band and supply the right papillary muscles. Because of this ... Cardiac muscle (like skeletal muscle) is characterized by striations - the stripes of dark and light bands resulting from the ... each papillary muscle receives the impulse at approximately the same time, so they begin to contract simultaneously just prior ... In cardiac muscle the T-tubules are only found at the Z-lines. When an action potential causes cells to contract, calcium is ...
... and papillary muscles" and the other titled "The Hand and the Heart", a topic Silverman also presented to the Laennec Society ... and papillary muscles". Co-authored with Hurst. American Heart Journal (1968) Sep;76(3):399-418. doi:10.1016/0002-8703(68)90237 ...
... particularly if the infarction causes dysfunction of the papillary muscle. Cardiogenic shock as a result of the heart being ... A rise in troponin occurs within 2-3 hours of injury to the heart muscle, and peaks within 1-2 days. The level of the troponin ... In response to growth factors secreted by macrophages, smooth muscle and other cells move into the plaque and act to stabilize ... Coronary artery bypass grafting is only considered when the affected area of heart muscle is large, and PCI is unsuitable, for ...
Each leaflet is connected via chordae tendineae to the anterior, posterior, and septal papillary muscles of the right ventricle ...
Rupture of the papillary muscle may also lead to acute mitral regurgitation and subsequent pulmonary edema and possibly even ... This may occur in the free walls of the ventricles, the septum between them, the papillary muscles, or less commonly the atria ... or a papillary muscle rupture. At a gross anatomical level, this staged is marked by a yellow pallor. Weeks 1-3 are marked on ... Muscle Tissue. In: Mescher AL. eds. Junqueira's Basic Histology: Text and Atlas, 15e New York, NY: McGraw-Hill Kumar, V., Abbas ...
Unique to the parachute mitral valve is that the chordae insert on one papillary muscle, rather than two distinct papillary ... the chordae as the strings and the papillary muscle as the harness. As discussed earlier, Shone's syndrome is a rare disorder ... muscles. Often, the chordae are short and thick and this combination of factors leads to restricted movement of the mitral ...
... is implicated in some follicular thyroid carcinomas and follicular-variant papillary thyroid carcinoma.[10] The mechanism for ... negative regulation of cardiac muscle cell apoptotic process. • ventricular septum development. Sources:Amigo / QuickGO. ...
Ali M.; Abussa A.; Hashmi H. (2007). "Papillary thyrpid carcinoma formation in a thyroglossal cyst. A case report". Libyan ... removal of one-eighth inch diameter core of tongue muscle superior to the hyoid at a 45 degree angle up to the foramen cecum to ... McNicoll MP, Hawkins DB, England K, Penny R, Maceri DR (1988). "Papillary carcinoma arising in a thyroglossal duct cyst". ...
pectinate muscles. *terminal sulcus. *ventricles *interventricular septum. *trabeculae carneae. *chordae tendineae. *papillary ...
During pregnancy, high progesterone levels elevate the risk of decreased muscle tone of the ureters and bladder, which leads to ...
The stratum lucidum (Latin for "clear layer") is a thin, clear layer of dead skin cells in the epidermis named for its translucent appearance under a microscope. It is readily visible by light microscopy only in areas of thick skin, which are found on the palms of the hands and the soles of the feet.[1][2] Located between the stratum granulosum and stratum corneum layers, it is composed of three to five layers of dead, flattened keratinocytes.[3][4] The keratinocytes of the stratum lucidum do not feature distinct boundaries and are filled with eleidin, an intermediate form of keratin. They are surrounded by an oily substance that is the result of the exocytosis of lamellar bodies accumulated while the keratinocytes are moving through the stratum spinosum and stratum granulosum.[citation needed] The thickness of the lucidum is controlled by the rate of mitosis (division) of the epidermal cells. In addition, melanosomes determine the darkness of the stratum lucidum. ...
The growth pattern is distinctive: typically producing a concentric band of tumor nests interspersed among the muscle and ... Ovarian serous cystadenoma / Pancreatic serous cystadenoma / Serous cystadenocarcinoma / Papillary serous cystadenocarcinoma. ... Small tumor nests may be camouflaged amongst the muscle or in periappendiceal fat; cytokeratin preparations best demonstrate ...
Papillary (Dermal papillae) · Reticular. Subcutaneous tissue. Panniculus/Pannus (Panniculus adiposus · Panniculus carnosus) · ...
... the cells of the papillary layer of the dermis are attached to the basement membrane by anchoring fibrils, which consist of ...
"Papillary Muscles". பார்த்த நாள் 7 March 2016. *↑ Ramin Assadi, MD; Chief Editor: Richard A Lange, MD, MBA (Jun 28, 2016). " ...
... is a tumor (-oma) including components derived from glands (adeno-) and muscle (-my-).[1] It is a type of complex ... Uterine papillary serous carcinoma. *Endometrial intraepithelial neoplasia. *Uterine clear-cell carcinoma. Cervix. *Cervical ...
Following this, the urethra re-establishes muscle tone by contracting the smooth muscle layer, and the bladder returns to a ... Urethral smooth muscle cells are mechanically coupled to each other to coordinate mechanical force and electrical signaling in ... During urination, the smooth muscle lining the urethra relaxes in concert with bladder contraction(s) to forcefully expel the ... The external urethral sphincter is a striated muscle that allows voluntary control over urination.[2] The internal sphincter, ...
Temporomandibular joints, muscles of mastication and malocclusions - Jaw joints, chewing muscles and bite abnormalities ... Papillary cystadenoma lymphomatosum. *Pleomorphic adenoma. *Sebaceous adenoma. *Malignant: Acinic cell carcinoma. * ...
In human anatomy, the eponychium is the thickened layer of skin surrounding fingernails and toenails. It can also be called the medial or proximal nail fold. Its function is to protect the area between the nail and epidermis from exposure to bacteria. The vascularization pattern is similar to that of perionychium.[1] In hoofed animals, the eponychium is the deciduous hoof capsule in fetuses and newborn foals, and is a part of the permanent hoof in older animals.[2] The word eponychium comes from Greek ἐπί (epí), meaning 'on top of', and ὀνῠ́χιον (onúkhion), meaning 'little claw'. ...
Yan X, Ding L, Li Y, Zhang X, Liang Y, Sun X, Teng CB (2012). "Identification and profiling of microRNAs from skeletal muscle ... It was found that miR-181a and miR-181c are overexpressed in Papillary Thyroid Carcinoma tumors, sufficiently to successfully ... Safdar A, Abadi A, Akhtar M, Hettinga BP, Tarnopolsky MA (2009). "miRNA in the regulation of skeletal muscle adaptation to ... It has been shown that miR-181 targets the homeobox protein Hox-A11 and participates in establishing muscle tissue ...
There are three types of these muscles. The third type, the papillary muscles give origin at their apices to the chordae ... The left ventricular muscle must relax and contract quickly and be able to increase or lower its pumping capacity under the ...
Its serum level is independent of muscle mass, making more accurate at estimating GFR than creatinine serum levels.[citation ...
Vitamin D and calcium work together in cases of maintaining homeostasis, creating muscle contraction, transmission of nerve ... reduced flexor and extensor tubercles (attachments areas for finger muscles on bones). ...
... muscle weakness due to autoantibodies). Tumors in the top of the lung, known as Pancoast tumors, may invade the local part of ... Papillary adenocarcinoma. *Giant-cell carcinoma. Small-cell carcinoma. *Combined small-cell carcinoma ...
Lowers the rate of gastric emptying, and reduces smooth muscle contractions and blood flow within the intestine ... Ovarian serous cystadenoma / Pancreatic serous cystadenoma / Serous cystadenocarcinoma / Papillary serous cystadenocarcinoma ...
... papillary muscle) · വാൽവുകൾ · cusps · Atrioventricular septum cardiac skeleton ...
The dermis is the layer of skin between the epidermis and subcutaneous tissue, and comprises two sections, the papillary dermis ... and related muscle and glands.[1] The major function of this system is as a barrier against the external environment.[2] ... arrector pili muscles, and the eccrine and apocrine glands.[21] The dermis contains two vascular networks that run parallel to ... and associated arrector pili muscle.[17] In the embryo, the epidermis, hair, and glands are from the ectoderm, which is ...
One or more glands may surround each hair follicle, and the glands themselves are surrounded by arrector pili muscles, forming ... The structure, consisting of hair, hair follicle, arrector pili muscles, and sebaceous gland, is an epidermal invagination ...
Papillary region[edit]. The papillary region is composed of loose areolar connective tissue. It is named for its fingerlike ... The skin has up to seven layers of ectodermal tissue and guards the underlying muscles, bones, ligaments and internal organs.[1 ... Its purpose is to attach the skin to underlying bone and muscle as well as supplying it with blood vessels and nerves. It ... The dermis is structurally divided into two areas: a superficial area adjacent to the epidermis, called the papillary region, ...
... hence RCA occlusion can cause papillary muscle rupture.[4] Function[edit]. The papillary muscles of both the right and left ... The papillary muscles are muscles located in the ventricles of the heart. They attach to the cusps of the atrioventricular ... The mitral valve papillary muscles in the left ventricle are called the anterolateral and posteromedial muscles.[4] ... A.P. Anterior papillary muscle.. In. Brachiocephalic artery (Innominate).. L.C.C. Left common carotid artery.. L.S. Left ...
Surrounded by a muscle, the sphincter of Oddi, this opens into the descending part of the duodenum.[4] ... A solid pseudopapillary tumour is a low-grade malignant tumour of the pancreas of papillary architecture that typically ... It also decreases the uptake of glucose in fat and muscle. Glucagon release is stimulated by low blood glucose or insulin ... particularly skeletal muscle), and promoting its use in the creation of proteins, fats and carbohydrates. Insulin is initially ...
Supersonic shear imaging of the stiffness during contraction of the hand muscles abductor digiti minimi (A) and first dorsal ... Conventional ultrasonography (lower image) and elastography (supersonic shear imaging; upper image) of papillary thyroid ... and they can determine the mechanical properties and state of muscles and tendons. ...
Elastin replacing collagen fibers of the papillary dermis and reticular dermis Elastosis perforans serpiginosa Degenerated ... of connective tissue and produced by fibroblasts and smooth muscle cells in arteries. These fibers can stretch up to 1.5 times ... Accumulation of fragmented elastotic material within the papillary dermis and transcutaneous elimination of elastotic fibers.[6 ...
Temporomandibular joints, muscles of mastication and malocclusions - Jaw joints, chewing muscles and bite abnormalities ... Papillary cystadenoma lymphomatosum. *Pleomorphic adenoma. *Sebaceous adenoma. *Malignant: Acinic cell carcinoma. * ...
... hence RCA occlusion can cause papillary muscle rupture.[4] Function[edit]. The papillary muscles of both the right and left ... The papillary muscles are muscles located in the ventricles of the heart. They attach to the cusps of the atrioventricular ... The mitral valve papillary muscles in the left ventricle are called the anterolateral and posteromedial muscles.[4] ... A.P. Anterior papillary muscle.. In. Brachiocephalic artery (Innominate).. L.C.C. Left common carotid artery.. L.S. Left ...
Papillary Muscle Infarction After Cardiopulmonary Resuscitation. Pier Giorgio Masci, Steven Dymarkowski, Jan Bogaert ... A, In this left ventricular short-axis T2-STIR-weighted image, the posterior papillary muscle has a hyperintense signal (arrow ... In T2 short-tau inversion-recovery weighted imaging (Figure, A), the posterior papillary muscle was strongly hyperintense, ... These findings indicate acute myocardial necrosis of posterior papillary muscle in an out-of-hospital cardiac arrest survivor ...
Spontaneous Rupture of a Papillary Muscle. Chi Young Shim, Young Jin Kim, Jang-Won Son, Hyuk-Jae Chang, Geu-Ru Hong, Jong-Won ... Spontaneous Rupture of a Papillary Muscle. Chi Young Shim, Young Jin Kim, Jang-Won Son, Hyuk-Jae Chang, Geu-Ru Hong, Jong-Won ... Spontaneous Rupture of a Papillary Muscle. Chi Young Shim, Young Jin Kim, Jang-Won Son, Hyuk-Jae Chang, Geu-Ru Hong, Jong-Won ... A papillary muscle rupture is a rare cardiac emergency and is most frequently associated with acute myocardial infarction. It ...
papillary muscles (heart, anatomy). FREE subscriptions for doctors and students... click here. You have 3 open access pages. ... Functionally, the papillary muscles are part of the respective valve complex. They prevent the cusps of a valve from being ... The papillary muscles of the heart are conical projections into the respective chamber of myocardium covered by endocardium. ...
... Tiffany Tamse,1,2 Avind ... "A Case of Idiopathic Hypereosinophilic Syndrome Causing Mitral Valve Papillary Muscle Rupture," Case Reports in Pediatrics, vol ...
Papillary muscle perfusion pattern. A hypothesis for ischemic papillary muscle dysfunction. Circulation. 1995;91:1714-8. ... Papillary muscle rupture complicating acute myocardial infarction: analysis of 17 patients. Am J Cardiol. 1983;51:373-7. ... 1a). Transthoracic echocardiography demonstrated an anterolateral papillary muscle (APM) rupture, which was confirmed by ... anterolateral papillary muscle rupture. Anatol J Cardiol. 2019;22:48-50.PubMedPubMedCentralGoogle Scholar ...
... Keine elektronische Fassung ... 1992)‎. Comparative ultrastructure of the tip of ventricular papillary muscle / F. Terasaki ... [‎et al.]‎. http://www.who.int/ ...
Papillary muscle dysfunction may occur as a result of (1) ischemia or infarction of a papillary muscle, (2) ventricular ... rupture of a papillary muscle, (4) inflammatory disease of a papillary muscle, and (5) interventricular conduction disturbances ... The Syndrome of Papillary Muscle Dysfunction: Its Clinical Recognition Annals of Internal Medicine; 59 (4): 508-520 ... Papillary Muscle Dysfunction. George E. Burch, M.D., F.A.C.P.; N. P. DePasquale, M.D., F.A.C.P. ...
Robotically Assisted Repair of a Partially Avulsed Papillary Muscle Secondary to Blunt Trauma. Thursday, January 18, 2007 ...
... determined by the voltage ratio method in superfused guinea pig papillary muscles under conditions of simulated ischemia (SI). ... Influence of rate-dependent cellular uncoupling on conduction change during simulated ischemia in guinea pig papillary muscles ...
IBCN 2018 STAG2 biomarker validation study using two independent cohorts of clinically-annotated papillary non muscle-invasive ... bladder cancer (NMIBC) tumors, aid in risk stratification in papillary NMIBC. ... IBCN 2018: STAG2 Biomarker for Prediction of Recurrence and Progression in Papillary Non-Muscle Invasive Bladder Cancer ... for prediction of progression to muscle invasion was evaluated in a progressor-enriched cohort of 253 patients with papillary ...
Background: The papillary muscles (PAP) have been implicated in arrhythmogenesis, largely based on theoretical considerations ... Few clinical studies have described papillary muscle arrhythmias. Objective: This study sought to describe ventricular ... Ventricular Arrhythmias Originating From a Papillary Muscle in Patients Without Prior Infarction: A Comparison With Fascicular ...
The aim of this study was to compare directly the efficiency of isolated rat papillary muscle preparations in isotonic and ... The results of previous studies suggest that the maximum mechanical efficiency of rat papillary muscles is lower during a ... Experiments were performed in vitro (27 degrees C) using left ventricular papillary muscles from adult rats. Each preparation ... The maximum net mechanical efficiency of rat papillary muscles performing afterloaded isotonic or sinusoidal length change ...
Rupture of a papillary muscle of the heart is considered a rare complication of myocardial infarction (1-5). Cederquist and ... Mitral Valve Regurgitation Caused by Infarcted Papillary Muscles: A Report of Fifteen Cases. Annals of Internal Medicine; 61 (4 ... Mitral Valve Replacement in a Patient with Mitral Regurgitation Secondary to Rupture of a Papillary Muscle ANGEL DE LA TORRE, M ... Mitral Valve Replacement in a Patient with Mitral Regurgitation Secondary to Rupture of a Papillary Muscle. Ann Intern Med. ...
No change in right ventricular papillary muscle contractility per unit muscle mass was observed as measured by maximum active ... Contractility of papillary muscle from rats exposed to 28 days of hypoxia, hypercapnia, and hypoxia with hypercapnia. ... Contractility of papillary muscle from rats exposed to 28 days of hypoxia, hypercapnia, and hypoxia with hypercapnia. ... A study was performed of the isometric contractile properties of isolated papillary muscle removed from rats exposed in a ...
... increase in basal contractile force of paced guinea pig papillary muscle (inactive). ...
Arrhythmic activity in reoxygenated guinea pig papillary muscles and ventricular cells.. H Hayashi, C Ponnambalam, T F McDonald ... Arrhythmic activity in reoxygenated guinea pig papillary muscles and ventricular cells.. H Hayashi, C Ponnambalam and T F ... Arrhythmic activity in reoxygenated guinea pig papillary muscles and ventricular cells.. H Hayashi, C Ponnambalam and T F ... Aftercontractions, delayed afterdepolarizations, and automaticity occurred in guinea pig papillary muscles that were ...
A single papillary muscle with chordal rupture in an adult Complete rupture of the anterolateral papillary muscle caused by ... Papillary muscle dyssynchrony: what is the optimal cut-off value? Uncommon insertion of papillary muscles and abnormal cardiac ... Anomalous papillary muscle insertion in hypertrophic cardiomyopathy Right papillary muscle sling: proof of concept and pilot ... Apically displaced papillary muscles mimicking apical hypertrophic cardiomyopathy Spontaneous papillary muscle rupture with ...
Interaction between selected sodium and potassium channel blockers in guinea pig papillary muscle.. L Wang, N Chiamvimonvat and ... Interaction between selected sodium and potassium channel blockers in guinea pig papillary muscle.. L Wang, N Chiamvimonvat and ... Interaction between selected sodium and potassium channel blockers in guinea pig papillary muscle.. L Wang, N Chiamvimonvat and ... Interaction between selected sodium and potassium channel blockers in guinea pig papillary muscle. ...
The papillary muscles (PMs) play an important role in normal cardiac function, helping to prevent leakage through the AV valves ...
Catheter ablation of ventricular tachycardia originating from the left posterior papillary muscle guided by the shadow of a ... Catheter Ablation of Ventricular Tachycardia Originating from the Left Posterior Papillary Muscle Guided by the Shadow of a ... It has been reported that catheter ablation of idiopathic focal ventricular arrhythmias originating from papillary muscles ( ... The anatomically complex structure of the papillary muscle complicates the manipulation and stability of catheters during ...
... can depict papillary muscle (PM) necrosis or fibrosis by late enhancement (LE) of PM, but its clinical significance in old ... Clinical significance of papillary muscle late enhancement detected via cardiac magnetic resonance imaging in patients with ... BACKGROUND: Contrast-enhanced cardiac magnetic resonance imaging (MRI) can depict papillary muscle (PM) necrosis or fibrosis by ...
Relationship between Developed Tension and Intracellular pH in Rat Papillary Muscle during Acute Respiratory and Metabolic Acid ...
... on the positive inotropic responses to catecholamines were investigated in isolated rabbit papillary muscles. 5-HT produced a ... The positive inotropic effect of 5-HT diminished greatly in muscles from rabbits pretreated with 6-hydroxydopamine. Thus, it is ... of the beta adrenoceptor-mediated positive inotropic responses to catecholamines in rabbit papillary muscles: direct ... of the beta adrenoceptor-mediated positive inotropic responses to catecholamines in rabbit papillary muscles: direct ...
End-systolic pressure-volume relation estimated from physiologically loaded cat papillary muscle contractions.. W J Paulus, V A ... End-systolic pressure-volume relation estimated from physiologically loaded cat papillary muscle contractions. ... End-systolic pressure-volume relation estimated from physiologically loaded cat papillary muscle contractions. ... End-systolic pressure-volume relation estimated from physiologically loaded cat papillary muscle contractions. ...
The valve leaflets are tethered by the chordae tendinae and the papilary muscles. The contraction of the papilary muscles then ... What is the function of the chordae tendinae and papillary muscles? Structure o valve. ... What is the function of the chordae tendinae and papillary muscles - ... Papillary muscles: The papillary muscles are the muscular attachments of the chordae. These along with the valve leaflets and ...
Posterior shift of the anterior papillary muscle in patients with heart failure: a potential role in the effect of cardiac ... Posterior shift of the anterior papillary muscle in patients with heart failure: a potential role in the effect of cardiac ... Posterior shift of the anterior papillary muscle in patients with heart failure: a potential role in the effect of cardiac ...
Papillary Muscle Infarction in Relation to Left Ventricular Infarct Distribution and Transmurality - Assessment by Delayed ... Papillary muscle infarction in relation to left ventricular infarct distribution and transmurality - assessment by delayed ... This study used delayed enhancement CMR (DE-CMR) and invasive angiography to evaluate relationships between papillary muscle ... Results demonstrate that papillary muscle infarction (PMI) parallels infarct transmurality and contractile dysfunction within ...
For larger muscles, screw clamps (SI-TM11) and spring clips (SI-TM9, SI-TM10) are available. ... This adapter is included with every Muscle Tester system.. When ordering tissue mounts, specify the tissue mount configuration ... For larger muscles, screw clamps (SI-TM11) and spring clips (SI-TM9, SI-TM10) are available. ...
  • The anterolateral and posteromedial papillary muscles of the left ventricle attach via chordae tendineae to the mitral valve . (wikipedia.org)
  • The mitral valve papillary muscles in the left ventricle are called the anterolateral and posteromedial muscles. (wikipedia.org)
  • The posteromedial muscle ruptures more frequently because it only has one source of blood supply, hence RCA occlusion can cause papillary muscle rupture. (wikipedia.org)
  • A large finger-like hypermobile material attached to the anterior mitral leaflet and an instable posteromedial papillary muscle were seen ( Figure 2D - 2F and Movies II and III in the online-only Data Supplement). (ahajournals.org)
  • Two-dimensional and 3-dimensional transesophageal echocardiography clearly visualized the ruptured head of the posteromedial papillary muscle, the freely mobile stump within the left ventricle, and severe eccentric mitral regurgitation ( Figure 3A - 3C and Movies IV-VI in the online-only Data Supplement). (ahajournals.org)
  • A coronary angiogram revealed a significantly calcified stenotic lesion on the mid left anterior descending artery ( Figure 4A ), but there was no critical stenosis on the right coronary system that could explain the infarct-related rupture of the posteromedial papillary muscle ( Figure 4B ). (ahajournals.org)
  • Anterolateral muscle blood supply: left anterior descending artery - diagonal branch (LAD) and left circumflex artery - obtuse marginal branch (LCX) Posteromedial muscle blood supply: right coronary artery - posterior interventricular artery (RCA) The posteromedial muscle ruptures more frequently because it only has one source of blood supply, hence RCA occlusion can cause papillary muscle rupture. (wikipedia.org)
  • Here, we present a case of a patient with a spontaneous posteromedial papillary muscle rupture related only to the physical and mechanical strains exerted on the papillary. (deepdyve.com)
  • Transoesophageal echocardiography clearly revealed severe eccentric mitral regurgitation with P3 and A3 prolapse, associated with the rupture of the posteromedial papillary muscle. (deepdyve.com)
  • C and D) Intraoperative image of partial posteromedial papillary muscle head rupture. (deepdyve.com)
  • The operation revealed a structurally normal mitral valve with partial rupture of the posterior head of the posteromedial papillary muscle (Fig. 1C and D). No signs of endocarditis or inflammatory process were discovered. (deepdyve.com)
  • The rupture of the anterolateral papillary muscle is less common than the posteromedial papillary muscle, as the anterolateral muscle has dual blood supply, whereas the posteromedial papillary muscle has a single blood supply. (scopemed.org)
  • Ischemic ventricular tachycardia from below the posteromedial papillary muscle, a particular entity: Substrate characterization and challenges for catheter ablation. (bvsalud.org)
  • In patients with ischemic ventricular tachycardia (VT), substrate may be "protected" by the posteromedial papillary muscle (PMPM), explaining failure of endocardial-only ablation. (bvsalud.org)
  • The PDA supplies the inferior wall, ventricular septum, and the posteromedial papillary muscle. (hyperleap.com)
  • The rupture of the posteromedial papillary muscle is most common seen in about 75% of cases. (biomedcentral.com)
  • On the other hand, the posteromedial papillary muscle is supplied only by the PDA. (bionity.com)
  • This makes the posteromedial papillary muscle significantly more susceptible to ischemia. (bionity.com)
  • This is a rare mechanical complication of myocardial infarction, which usually affects the posteromedial papillary muscle. (houstonmethodist.org)
  • It occurs in approximately 1% of MIs, and posteromedial papillary muscle is involved more frequently than anterolateral muscle. (medscape.com)
  • Chordae tendineae from posteromedial papillary muscle inserting into the anterior mitral leaflet--an unusual presentation. (bvsalud.org)
  • Posteromedial muscle is 6-12x more likely because blood supply is through PDA only. (scvmcmed.com)
  • Papillary muscle rupture can be caused by a myocardial infarct , and dysfunction can be caused by ischemia . (wikipedia.org)
  • In T2 short-tau inversion-recovery weighted imaging ( Figure , A), the posterior papillary muscle was strongly hyperintense, which indicated the presence of myocardial edema. (ahajournals.org)
  • These findings indicate acute myocardial necrosis of posterior papillary muscle in an out-of-hospital cardiac arrest survivor without angiographic evidence of coronary artery disease. (ahajournals.org)
  • A, In this left ventricular short-axis T2-STIR-weighted image, the posterior papillary muscle has a hyperintense signal (arrow) caused by increased water content (myocardial edema). (ahajournals.org)
  • C, On late contrast-enhanced imaging, the posterior papillary muscle is strongly enhanced (arrow), whereas no other areas of myocardial gadolinium enhancement are detected. (ahajournals.org)
  • Karaduman A, Balaban İ, Keskin B, Geçmen Ç, Kahveci G. A rare complication of posterior myocardial infarction: anterolateral papillary muscle rupture. (springer.com)
  • Papillary muscle rupture complicating acute myocardial infarction: analysis of 17 patients. (springer.com)
  • Rupture of a papillary muscle of the heart is considered a rare complication of myocardial infarction (1-5). (annals.org)
  • Clinical significance of papillary muscle late enhancement detected via cardiac magnetic resonance imaging in patients with single old myocardial infarction. (biomedsearch.com)
  • BACKGROUND: Contrast-enhanced cardiac magnetic resonance imaging (MRI) can depict papillary muscle (PM) necrosis or fibrosis by late enhancement (LE) of PM, but its clinical significance in old myocardial infarction (OMI) has been little understood. (biomedsearch.com)
  • Valve repair for tricuspid papillary muscle rupture late after percutaneous coronary intervention Kanemitsu, Shinji;Sakamoto, Shunsuke;Yamamoto, Naoki;Shimpo, Hideto 2018-05-03 00:00:00 Abstract Papillary muscle rupture is a rare complication after myocardial infarction. (deepdyve.com)
  • The development of tricuspid regurgitation after right ventricular myocardial infarction caused by papillary muscle rupture is extremely rare. (deepdyve.com)
  • Tricuspid papillary muscle rupture, Tricuspid valve repair, Myocardial infarction INTRODUCTION Papillary muscle rupture (PMR) is a fairly rare, but often fatal, complication after myocardial infarction (MI). (deepdyve.com)
  • B) Pathological examination of the end of the ruptured papillary muscle showing neutrophil invasion without fibrosis, indicative of the inflammatory phase of myocardial infarction. (deepdyve.com)
  • CTGF expression in the papillary muscles of the RHD patients is significantly increased, which suggests CTGF may play an important role in myocardial fibrosis of RHD. (onlinejacc.org)
  • Acute mitral regurgitation can be precipitated by acute myocardial infarction due to rupture of the anterolateral papillary muscle. (biomedcentral.com)
  • Rupture of a papillary muscle is an uncommon but often fatal complication of acute myocardial infarction (MI) which is responsible for approximately 5% of death after MI [ 1 ]. (biomedcentral.com)
  • Acute myocardial infarct (MI), commonly known as a heart attack, is a condition characterized by ischemic injury and necrosis of the cardiac muscle. (medscape.com)
  • Although coronary artery disease is accelerated in the diabetic state, it has been recognized for a number of years that diabetes independently impairs myocardial performance by decreasing cardiac muscle function ( 1 , 2 ). (diabetesjournals.org)
  • Papillary muscle rupture is one of the many known complications of myocardial infarction and can have deadly consequences. (shmabstracts.org)
  • Physicians must maintain a high degree of suspicion for potentially deadly sequelae of myocardial infarction such as papillary muscle rupture even without clear angiographic evidence of myocardial infarction. (shmabstracts.org)
  • Although necrosis of the left ventricular papillary muscles during acute myocardial infarction is common, rupture of the anterolateral papillary muscle due to occlusion of high lateral branch is rare. (scirp.org)
  • Although necrosis of the papillary muscle (PM) potentially occurs due to acute myocardial infarction (AMI), rupture of the anterolateral PM is rare because of its dual blood supply. (scirp.org)
  • It has been reported that halothane, enflurane, and isoflurane all appear to reduce myocardial Ca 2+ sensitivity at greater than 0.5 minimum alveolar concentration (MAC) in intact muscle. (asahq.org)
  • Objective: To analyze the clinical manifestations of a huge inverted T wave and to summarize the causes of misdiagnosis of deformed papillary muscle as myocardial ischemia. (authorea.com)
  • A 12-lead ECG with deformed papillary muscles shows that a huge inverted T wave is not a feature of myocardial ischemia. (authorea.com)
  • Conclusion: Conventional 12-lead electrocardiogram shows that the giant inverted T wave of the deformed papillary muscles is diagnosed as myocardial ischemia, which is a misdiagnosis. (authorea.com)
  • This is a case of acute papillary muscle rupture secondary to myocardial infarction leading to cardiogenic shock. (cardiovascimaging.com)
  • Cine image of left ventricular inflow/outflow (Data Supplement Movie I) showed eccentric mitral regurgitation caused by posterior papillary muscle dysfunction. (ahajournals.org)
  • B, After administration of gadolinium-DTPA, first-pass perfusion imaging clearly shows a perfusion defect localized to the posterior papillary muscle (arrow) (see Data Supplement Movie II). (ahajournals.org)
  • Catheter ablation of ventricular tachycardia originating from the left posterior papillary muscle guided by the shadow of a multipolar catheter. (biomedsearch.com)
  • Electroanatomical mapping using a multipolar catheter identified the earliest activation originating from the posterior papillary muscle (PPM) where prepotentials preceding the local ventricular electrogram were observed. (biomedsearch.com)
  • Tavakoli R, Weber A, Vogt P, Brunner H‑P, Pretre R, Turina M. Surgical management of acute mitral valve regurgitation due to post-infarction papillary muscle rupture. (springer.com)
  • Papillary muscle dysfunction may occur as a result of (1) ischemia or infarction of a papillary muscle, (2) ventricular dilatation (including aneurysm), (3) rupture of a papillary muscle, (4) inflammatory disease of a papillary muscle, and (5) interventricular conduction disturbances. (annals.org)
  • Impact of Papillary Muscle Infarction on Ischemic Mitral Regurgitation Assessed by Magnetic Resonance Imaging. (annals.org)
  • This study used delayed enhancement CMR (DE-CMR) and invasive angiography to evaluate relationships between papillary muscle and left ventricular (LV) chamber wall infarction following ST segment elevation MI (STEMI). (harvard.edu)
  • Results demonstrate that papillary muscle infarction (PMI) parallels infarct transmurality and contractile dysfunction within the adjacent LV wall. (harvard.edu)
  • In the absence of coronary artery disease, other conditions may explain the infarction of papillary muscle. (deepdyve.com)
  • Other potential mechanisms for isolated papillary muscle infarction are blunt trauma and eosinophil-mediated damage, but these mechanisms were also excluded. (deepdyve.com)
  • Acute mitral regurgitation is usually associated with inferior MI due to ischemia or infarction of the papillary muscle. (medscape.com)
  • Mitral valve repair, Papillary muscle, Mitral valve regurgitation INTRODUCTION Acute mitral regurgitation resulting from papillary muscle rupture (PMR) is a rare life-threatening condition frequently associated with coronary artery disease. (deepdyve.com)
  • Cardiovascular collapse with shock (cardiogenic shock) may be seen in individuals with acute MR due to papillary muscle rupture, rupture of a chorda tendinea or infective endocarditis of the mitral valve. (hyperleap.com)
  • Thank you Naina for presenting the case of an elderly man with 20 packyear smoking history presenting with acute onset of dyspnea and scant hemoptysis, found to have new onset A fib and L heart failure secondary to severe mitral regurgitation resulting from papillary muscle rupture! (scvmcmed.com)
  • Transthoracic echocardiography demonstrated an anterolateral papillary muscle (APM) rupture, which was confirmed by transoesophageal echocardiography (Fig. 1 b). (springer.com)
  • C and D) Transthoracic echocardiography revealing the tricuspid anterior leaflet prolapse caused by complete rupture of the papillary muscle (arrow) and severe tricuspid regurgitation. (deepdyve.com)
  • c) Echocardiography revealed a ruptured anterior papillary muscle (arrowhead). (scirp.org)
  • Echocardiography showed severe mitral regurgitation due to a ruptured anterolateral papillary muscle, and emergency surgery revealed necrosis of this muscle. (houstonmethodist.org)
  • Combined with multi-factor logistic regression analysis of echocardiography and electrocardiogram, we evaluated 11 cases of unique clinical malformed papillary muscles with lowered position. (authorea.com)
  • Echocardiography showed that the anterolateral papillary muscle base of 11 patients originated from the apex 1/3. (authorea.com)
  • A hypothesis for ischemic papillary muscle dysfunction. (springer.com)
  • Papillary Muscle Dysfunction. (annals.org)
  • Papillary muscle dysfunction results in mitral regurgitation and an apical systolic murmur. (annals.org)
  • The characteristics of the murmur vary depending upon the etiology of the papillary muscle dysfunction. (annals.org)
  • How is papillary muscle dysfunction diagnosed? (healthtap.com)
  • Papillary muscle dysfunction causes abnormality in closing the mitral valve and mitral insufficiency results. (healthtap.com)
  • What causes the murmur associated with papillary muscle dysfunction? (healthtap.com)
  • The murmur of mitral regurgitation is that associated with papillary muscle dysfunction. (healthtap.com)
  • Can papillary muscle dysfunction be present with only a faint murmur, but no symptoms at all, no prior heart attack, normal echo & ekg? (healthtap.com)
  • Therefore one cannot have a normal echo if they have papillary muscle dysfunction. (healthtap.com)
  • To investigate whether cardiac dysfunction in prefailure cardiomyopathic (CM) hamster hearts is due to Ca 2+ overload or alternatively to decreased availability of Ca 2+ in the sarcoplasmic reticulum (SR), the Ca 2+ channel agonist, BAY K 8644, was used to compare the effects of increased Ca 2+ influx on function and subcellular Ca 2+ distribution in papillary muscles from hearts of 110-day-old CM and normal hamsters. (elsevier.com)
  • A rupture or dysfunction of these muscles, as can be caused by a heart infarct and Ischemia (respectively), can give rise to a complicated condition known as Mitral Valve Prolapse. (knowyourbody.net)
  • Since reduction annuloplasty alone for ischemic mitral regurgitation (MR) cannot prevent late recurrence of MR or improve survival for those with left ventricular (LV) dysfunction, and the surgical approach to this etiology is still controversial, we conducted a study to assess the efficacy of the additional papillary muscle approximation (PMA) procedure for ischemic MR by comparing the different subtypes of PMA. (biomedcentral.com)
  • We adopted a submitral procedure named papillary muscle approximation (PMA) as a radical procedure for ischemic MR with severe LV dysfunction. (biomedcentral.com)
  • The aim of this work is to detect and assess papillary muscle traction [PMT] in patients with idiopathic MVP in a trial to correlate it with any autonomic dysfunction as evaluated by head -up-tilt test [HUTT]. (bvsalud.org)
  • Normal mitral valve function depends upon the maintenance of the proper spatial relationships between the papillary muscles, the chordae tendinae, and the mitral valve leaflets throughout the cardiac cycle. (annals.org)
  • Nipple-shaped projections of ventricular muscle to which the tendinous cords (see chordae tendinae) of the atrioventricular valves are attached. (oup.com)
  • The valve leaflets are tethered by the chordae tendinae and the papilary muscles. (healthtap.com)
  • What are the enlarged muscles attached to chordae tendinae? (healthtap.com)
  • The papillary muscles attach to the cusps of the atrioventricular valves (a.K.A. The mitral and tricuspid valves) via the chordae tendinae and contract to prevent inversion or prolapse of these valves. (healthtap.com)
  • Which heart valves are anchored by chordae tendinae to the heart muscle? (healthtap.com)
  • Think of valve as a parachute, chordae tendinae are the "ropes" that anchor the valve leaflets or cusps to the heart muscle. (healthtap.com)
  • The papillary muscle is actually considered as the active anchoring point of the chordae tendinae to the left ventricle wall, and it works by an independent mechanism as a shock absorber to compensate for geometric changes of left ventricular wall and to maintain the basic mitral valve geometry during the cardiac cycle [4]. (deepdyve.com)
  • The papillary muscles extend from the walls of the heart to valves by cartilaginous connections called chordae tendinae. (hyperleap.com)
  • The third type, the papillary muscles, give origin at their apices to the chordae tendinae which attach to the cusps of the tricuspid valve and to the mitral valve. (hyperleap.com)
  • We studied the effects of increasing stimulation frequency from 0.5 to 2.0 Hz on the simultaneous changes in the maximum rate of rise (Vmax) of the action potential upstroke, conduction velocity, and internal longitudinal resistance (ri) determined by the voltage ratio method in superfused guinea pig papillary muscles under conditions of simulated ischemia (SI). (rti.org)
  • Arrhythmic activity in reoxygenated guinea pig papillary muscles and ventricular cells. (ahajournals.org)
  • Aftercontractions, delayed afterdepolarizations, and automaticity occurred in guinea pig papillary muscles that were reoxygenated after hypoxic conditioning. (ahajournals.org)
  • Interaction between selected sodium and potassium channel blockers in guinea pig papillary muscle. (aspetjournals.org)
  • In this study, the interactions between the prolongation of action potential duration (APD) by a potassium channel blocker and the reduction in the maximal upstroke velocity of phase 0 of action potential (Vmax) by sodium channel blockers were investigated in guinea pig papillary muscle using conventional microelectrode techniques. (aspetjournals.org)
  • For a comprehensive understanding of its antiarrhythmic mechanisms in the same preparations, amiodarone (50 μM) was employed as it would be in the clinical setting and applied to guinea pig papillary muscles impaled by microelectrodes, paced at different rates, and superfused with various concentrations of potassium ([K] e ). (elsevier.com)
  • Chatamra, KR , Suleiman, MS & Chapman, RA 1993, The influence of extracellular pH (pH o upon the intracellular activity of sodium a N a i in isolated guinea-pig papillary muscle perfused with a medium free of divalent cations . (bris.ac.uk)
  • We studied 45 patients who underwent mitral annuloplasty and papillary muscle approximation (PMA) for ischemic MR between 2003 and 2012. (biomedcentral.com)
  • METHODS: From March 2003 to May 2010, 55 patients with severe ischemic MR who had undergone papillary muscle (PPM) relocation in conjunction with mitral annuloplasty in our institutions were enrolled. (unipa.it)
  • This study reports the clinical and echocardiographic outcomes of papillary muscle relocation combined with mitral annuloplasty.Methods From 2003, 115 patients with severe ischemic mitral regurgitation who underwent papillary muscle relocation plus nonrestrictive mitral annuloplasty and coronary artery bypass grafting were retrospective analyzed. (unipa.it)
  • 95% of the patients were in New York Heart Association functional class I and II.Conclusions In patients with ischemic mitral regurgitation, papillary muscle relocation plus nonrestrictive mitral annuloplasty promotes a significant reversal in left ventricular remodeling, with a considerable decrease in tenting area and coaptation depth. (unipa.it)
  • We present a 70-year-old man with massive tricuspid regurgitation caused by papillary muscle rupture after percutaneous coronary intervention to the right coronary artery involving a stent. (deepdyve.com)
  • MR can be caused by papillary muscle rupture, especially 3-7 days post MI. (scvmcmed.com)
  • The results of previous studies suggest that the maximum mechanical efficiency of rat papillary muscles is lower during a contraction protocol involving sinusoidal length changes than during one involving afterloaded isotonic contractions. (biologists.org)
  • The anterior papillary muscle was found to be ruptured, resulting in the anterior tricuspid leaflet prolapse (Fig. 2A, Video 2). (deepdyve.com)
  • Figure 2: View largeDownload slide (A) Intraoperative image showing papillary muscle rupture of the tricuspid anterior leaflet. (deepdyve.com)
  • We report two neonates with profound cyanosis and severe tricuspid regurgitation caused by rupture of the papillary muscle supporting the anterior leaflet, without other structural heart defects. (elsevier.com)
  • The expression of CTGF mRNA and CTGF protein were detected with semiquantitative RT-PCR technique and immunohistochemistry technology in the papillary muscles cell from 38 RHD patients and 20 normal papillary muscles samples. (onlinejacc.org)
  • A band, mitochondrial, and junctional SR Ca 2+ were measured by electron probe microanalysis in CM and normal papillary muscles, which were either untreated or pretreated with BAY K 8644. (elsevier.com)
  • Inhibition by 5-hydroxytryptamine of the beta adrenoceptor-mediated positive inotropic responses to catecholamines in rabbit papillary muscles: direct interaction with beta adrenoceptors. (aspetjournals.org)
  • The effects of 5-hydroxytryptamine (5-HT) on the positive inotropic responses to catecholamines were investigated in isolated rabbit papillary muscles. (aspetjournals.org)
  • Spontaneous mechanical rupture of a papillary muscle effectively resolved by mitral valve repair Fiore, Antonio;Piscitelli, Mariantonietta;Bergoend, Eric;Couetil, Jean Paul 2018-04-01 00:00:00 Abstract We report a case of spontaneous mechanical papillary muscle rupture. (deepdyve.com)
  • Dynamic stiffness of papillary muscle during contraction and relaxation. (elsevier.com)
  • The contraction and relaxation of cardiac muscle continues at a rhythmic pace until death unless the muscle is injured in some way. (thefreedictionary.com)
  • We found: (1) Muscle twitch tension (P-0) and contraction and relaxation rates were significantly lower in diabetic controls than in the other groups. (cu.edu.tr)
  • The anterior, posterior, and septal papillary muscles of the right ventricle each attach via chordae tendineae to the tricuspid valve . (wikipedia.org)
  • Functionally, the papillary muscles are part of the respective valve complex. (gpnotebook.co.uk)
  • Mitral Valve Regurgitation Caused by Infarcted Papillary Muscles: A Report of Fifteen Cases. (annals.org)
  • The contraction of the papilary muscles then in turn cause movement of teh valve leaflets allowing opening. (healthtap.com)
  • My echo says my mitral valve anterior papillary muscle is "prominent. (healthtap.com)
  • Almost all cases occur in the papillary muscle of the mitral valve. (deepdyve.com)
  • We performed tricuspid valve repair with a reimplanted papillary muscle in situ using neither artificial chordae nor a prosthetic valve. (deepdyve.com)
  • Almost all cases occur on the left ventricular side of the papillary muscle in the mitral valve. (deepdyve.com)
  • The papillary muscles samples were obtained from patients with RHD during mitral valve replacement. (onlinejacc.org)
  • The chordae tendineae are attached to papillary muscles that cause tension to better hold the valve. (hyperleap.com)
  • The chordae tendineae (tendinous cords), colloquially known as the heart strings, are tendon-resembling fibrous cords of connective tissue that connect the papillary muscles to the tricuspid valve and the bicuspid valve in the heart. (hyperleap.com)
  • The chordae tendineae are inelastic tendons attached at one end to papillary muscles in the left ventricle, and at the other to the valve cusps. (hyperleap.com)
  • The muscles anchor themselves to the cusps or flaps of the atrioventricular valves, such as the tricuspid and mitral valve through the chordae tendineae . (knowyourbody.net)
  • Background: In patients with hypertrophic cardiomyopathy and left ventricular outflow tract (LVOT) obstruction, but without basal septal hypertrophy, we sought to identify mitral valve (MV) and papillary muscle (PM) abnormalities that predisposed to LVOT obstruction, using echo and cardiac magnetic resonance. (elsevier.com)
  • Repair of the tricuspid valve was performed by reimplantation of the ruptured papillary muscle head, after initial stabilization using extracorporeal membrane oxygenation. (elsevier.com)
  • The papillary muscles tether the mitral valve (the valve between the left atrium and the left ventricle) and the tricuspid valve (the valve between the right atrium and the right ventricle ) to the wall of the heart. (bionity.com)
  • If the papillary muscles are not functioning properly, the mitral valve leaks during contraction of the left ventricle. (bionity.com)
  • During surgery, papillary muscle anomaly, with two supernumerary muscles inserted at the base of the anterior cusp of the mitral valve, obstructing the left ventricular outflow tract was identified. (rbccv.org.br)
  • The papillary anomalous muscles and the subaortic membrane were resected through aortotomy after soft traction of the aortic valve cusps ( Figures 1 to 4 ). (rbccv.org.br)
  • Few clinical studies have described papillary muscle arrhythmias. (nih.gov)
  • The differential diagnosis between the relatively rare occurrence of a primary carcinoma arising in ectopic thyroid tissue and the more frequent presence of cervical lymph node metastasis from papillary thyroid carcinoma (PTC) might represent a difficult challenge in the clinical practice. (minervamedica.it)
  • In clinical practice, referred to as the lateral rectus muscle. (thefreedictionary.com)
  • Contractions of the papillary muscles assist the tendinous cords in preventing the valves from being thrust out into the atrial cavity during ventricular systole. (oup.com)
  • End-systolic pressure-volume relation estimated from physiologically loaded cat papillary muscle contractions. (ahajournals.org)
  • Muscle work output and heat production were measured during a series of 40 contractions using a contraction protocol designed to mimic in vivo papillary muscle activity. (biologists.org)
  • I ratio in isometric and working contractions, which was made using mouse skeletal muscle ( Woledge and Yin, 1989 ), revealed that the ratio was greater in shortening contractions (1.25) than in isometric contractions (1.0). (biologists.org)
  • The last stages of swallowing and of peristalsis are actually series of contractions by the muscles in the walls of the organs involved. (thefreedictionary.com)
  • Unlike the involuntary muscles, which can remain in a state of contraction for long periods without tiring and are capable of sustained rhythmic contractions, the voluntary muscles are readily subject to fatigue. (thefreedictionary.com)
  • Measurements of the effects of isoflurane on crossbridge cycling kinetics during tetanic contractions, which provide a steady state level of activation in intact cardiac muscle, have not been previously reported. (asahq.org)
  • The LCX supplies the posterolateral left ventricle and the anterolateral papillary muscle. (hyperleap.com)
  • Echo density visualized in the left ventricle suggested partial ruptured anterolateral papillary muscle (fig 2 ). (biomedcentral.com)
  • There have been no prior studies focused on the electrocardiogram (ECG) features and ablation of PVC/VT arising from the septal papillary muscle of the right ventricle. (elsevier.com)
  • The interior of the right ventricle has irregular muscle elevations called trabeculae carneae . (wikidoc.org)
  • It carries part of the right bundle branches of the AV bundle, necessary for electrical conduction, to the anterior papillary muscle of the right ventricle . (wikidoc.org)
  • Recent studies have reported that idiopathic focal ventricular arrhythmias (VAs) can originate from the papillary muscles (PAMs) in the left ventricle (LV) and it is consistent that catheter ablation of these VAs is challenging as compared with the other VAs in the LV (1-4) . (onlinejacc.org)
  • From each left ventricle, a papillary muscle of 5-6 mm in length 1-1.5 mm in width and 32 ± 4 mg in weight was isolated. (dergisi.org)
  • The cardiac papillary muscle velocity attenuation after active stretching was significantly accelerated in severe stretched higher preload muscle. (alliedacademies.org)
  • A bedside echocardiogram was ordered, which demonstrated papillary muscle rupture with severe mitral regurgitation. (cardiovascimaging.com)
  • It is believed that via this conduction route that the anterior papillary muscle achieves its coordinated contraction. (wikidoc.org)
  • RV Septal Papillary Muscle VT Introduction Premature ventricular complexes (PVCs) and ventricular tachycardia (VT) arising from papillary muscles of both ventricles have recently been described. (elsevier.com)
  • The effects of chronic respiratory failure (hypoxia and hypercapnia) on the contractile properties of cardiac muscle are not established. (bmj.com)
  • Rat cardiac muscle adapts successfully to the altered acid-base environment and increased work load associated with prolonged exposure to hypoxia and mild hypercapnia. (bmj.com)
  • Take a peek at these assistive images to know about the physical appearance of this cardiac muscle. (knowyourbody.net)
  • The efficiency of mechanical work generation by cross-bridges in cardiac muscle is poorly established because it is difficult to experimentally separate the initial and recovery energy costs. (biologists.org)
  • We tested the hypothesis that nitric oxide has a positive inotropic effect on mammalian cardiac muscle contractility and that this effect sums with the positive inotropic effect of β 1 -adrenergic agonists when both are present. (ingentaconnect.com)
  • Background: Hypertrophic cardiomyopathy (HC) is characterized by left ventricular (LV) hypertrophy and associated with papillary muscle (PM) abnormalities. (eur.nl)
  • We present a case report of a 42 year old male presenting with heart failure being diagnosed to have mitral regurgitation from the partial rupture of the anterolateral papillary muscle due to coronary artery disease. (biomedcentral.com)
  • We present a rare case of anterolateral papillary muscle rupture caused by occlusion of a high lateral branch of the left coronary artery. (scirp.org)
  • The coronary circulation is the circulation of blood in the blood vessels that supply blood to and from the heart muscle itself. (bionity.com)
  • Although blood fills the chambers of the heart, the muscle tissue of the heart, or myocardium , is so thick that it requires coronary blood vessels to deliver blood deep into it. (bionity.com)
  • These arteries, when healthy, are capable of autoregulation to maintain coronary blood flow at levels appropriate to the needs of the heart muscle . (bionity.com)
  • In addition, TTE can identify and quantify the degree of MR and rule out other causes of MR, such as secondary to papillary muscle rupture and primary MR. Other valuable information include the presence of other valvular pathology, the degree of ventricular dysfunctions, free wall rupture, cardiac infront of tamponade, pulmonary embolism, and aortic dissection/rupture. (springer.com)
  • The critical diagnosis of this neoplasm is often difficult because of its similarity with other primary or secondary papillary lesions of the pineal region, including parenchymal pineal tumors, papillary ependymoma, papillary meningioma, choroid plexus papilloma, and metastatic papillary carcinoma. (wikipedia.org)
  • The muscle contracts to avert prolapse or inversion of the atrioventricular valves. (knowyourbody.net)
  • It is tendon-like "strings of heart" that established a connection between the papillary muscles and atrioventricular valves. (knowyourbody.net)
  • The papillary muscles of both the right and left ventricles begin to contract shortly before ventricular systole and maintain tension throughout. (wikipedia.org)
  • Experiments were performed in vitro (27 degrees C) using left ventricular papillary muscles from adult rats. (biologists.org)
  • In theory, the papillary muscle works as a shock absorber that compensates for geometric changes of left ventricular wall. (deepdyve.com)
  • Ventricular systole induces self-contraction such that pressure in both left and right ventricles rises to a level above that in the two atrial chambers, thereby closing the tricuspid and mitral valves-which are prevented from inverting by the chordae tendineae and the papillary muscles. (hyperleap.com)
  • The Papillary muscles located in the left and right ventricles start contracting shortly prior to the ventricular systole. (knowyourbody.net)
  • Experiments were performed in vitro (30°C) using preparations dissected from rat left ventricular papillary muscles ( N =13). (biologists.org)
  • The anterolateral papillary muscle receives two blood supplies: left anterior descending (LAD) artery and the left circumflex artery (LCX). (bionity.com)
  • During surgery, a rare condition was identified: presence of papillary muscle anomaly associated with the subaortic membrane as a cause of obstruction of the left ventricular outflow tract. (rbccv.org.br)
  • The purpose of this study was to investigate the effects of telmisartan (5 x 10(-5) M) on the mechanical response of left ventricular papillary muscle in rats with streptozotocin-induced diabetes mellitus. (cu.edu.tr)
  • Previous studies of transmural left ventricular (LV) strains suggested that the myocardium overlying the papillary muscle displays decreased deformation relative to the anterior LV free wall or significant regional heterogeneity. (wustl.edu)
  • 2. The method of claim 1 , wherein the first end of the elongate member extends through the first wall between a left anterior descending artery and a postero-medial papillary muscle. (google.com)