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Radnoti Glass Technology
                        The Radnoti Working Heart System
    Isolated Perfused




                                                       Presented by:
                                      Radnoti Glass Technology, Inc.




www.radnoti.com
 800-428-1416
                                                                       2007
Radnoti Glass Technology
                        Introduction
    Isolated Perfused



                        The Isolated Perfused Heart System, as originated by Oscar Langendorff more than a century ago, has become a
                        predominant technique in pharmacological and physiological research. The technique allows the examination of
                        cardiac contractile strength (inotropic effects), heart rate (chronotropic effects) and vascular effects without the
                        complications of an intact animal model. From its simple beginning the technique and equipment has evolved to
                        include both constant pressure and constant flow models in a working heart mode as well as both recirculating
                        and non recirculating modes. The Radnoti Isolated Perfused Heart System has the capacity to function in any of
                        these configurations allowing flexibility in experimental research and design.


                        This presentations intention is a quick reference to instrumentation of the Radnoti Isolated Working Heart System.




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 800-428-1416
Radnoti Glass Technology
                        Experimental Options
                        There are a great number of physiological parameters that can be measured in the Isolated
                        Perfused Heart preparation.
    Isolated Perfused




                        A pressure measurement while in constant flow mode will show the resistance of the heart,
                        indicating vasodilatation or vasoconstriction.

                        A left ventricular pressure measurement made using a combination of pressure transducer,
                        flexible balloon catheter and latex balloon can serve as an indicator of contractile force.
                        Electrocardiograms (ECGs) are readily obtained using surface electrodes of monopolar, bipolar
                        construction or needle electrodes that pierce the heart muscle and are of interest in studies
                        involving arrhythmias.

                        Oxygen consumption can be determined with dual oxygen electrodes, one placed in the perfusate
                        stream entering the heart, the other monitoring the effluent leaving the coronary sinus. This
                        effluent can be removed through the use of a peristaltic pump and then transferred to the second
                        oxygen electrode.

                        Similarly, ion selective electrodes can be placed in the effluent or perfusate stream or
                        oxygenation chamber of the Radnoti Isolated Perfused Heart apparatus thus permitting
                        measurement of pH and other cations and anions.

                        Radiolabelled compounds can be used for metabolic studies, as well as the release or uptake of
                        various ions or substrates.
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                        Optical studies measuring intracellular constituents have been performed on the fluorescence of
                        endogenous or exogenous fluorescent compounds.
Radnoti Glass Technology
                        Instrumentation of the System
                                                                                           Perfusion Pressure and Ejection
                                                                                           Pressure
                                                                                           159905
    Isolated Perfused



                           LVP
                           159907 IVP transducer & Balloon or 159905 Pressure Transducer   Perfusion pressure on Aortic Cannula
                           with 170424 flexible balloon catheter and balloon               (Langendorff constant flow)

                                                                                           Ejection Pressure on stopcock of Aortic
                                                                                           Cannula feed to Compliance loop
                                                                                           (Working Heart)




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Radnoti Glass Technology
                        Instrumentation of the System cont.
    Isolated Perfused




                              ECG
                              #140155 ECG electrodes and ML132 Bioamp


                                                                        Flow-
                                                                        Perfusion
                                                                        IUF1000 Flow Meter mounted at
                                                                        feed to atrial cannula
                                                                        Ejection
                                                                        IUF1000 Flow Meter mounted
                                                                        inline on compliance loop



                                          Pacing
                                          #140157 Pacing electrodes
                                          GR-SD9 Stimulator




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Radnoti Glass Technology
                        Instrumentation of the System cont.
    Isolated Perfused




                                                     O2
                                                     MI-730 Dip-type O2 microelectrode
                                                     O2-ADPT Oxygen Adapter




                                                                                                 pH
                                                                                                 MI-410 Micro-combination pH microelectrode
                                                                                                 MV-ADPT Millivolt Adapter




                                           Flexible Balloon Catheter
                                           #170423 The balloon catheter is
                                           for ventricular insertion. It is a
                                           simple, reliable way to measure
                                           left ventricular isovolumetric                Temperature
www.radnoti.com                            pressure.                                     BAT-12 Microprobe Thermometer
 800-428-1416
Radnoti Glass Technology
                        Typical Values
    Isolated Perfused



                        These values are obtained from a variety of sources and are displayed to demonstrate the approximate ranges of
                        these values. Values are for adult animals. In vivo heart rate and blood pressure are taken at rest. Cation values
                        are from serum. Left ventricular volume (LVV) is given for a balloon inserted into the left ventricle. CF (coronary
                        flow) is given for a saline solution at 50-60 mmHg




                                                   Rate Bpm      BP mm/Hg      Na,mM         K,mM     Ca,mM     Mg,mM     LVVml heart     Heart



                                    Cat            110-140       125/70        163           4.4      1.3       0.7       0.7-2.4         2-3

                                    Rat            330-360       129/91        140           5.7      2.6       1.1       0.1-0.2         8-10

                                    Guinea Pig     280-300       120/170       145           7.4      2.6       1.2       0.1-0.2         5-8

                                    R.pipens       37-60         31/21



                                    Carp           40-78         43



                                    Rabbit         205-220       110/73        155           4.6      3.5       1.6       0.4-0.7         2-5
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Radnoti Glass Technology
                        Pumps Overview
                        Perfusate or Buffer Delivery:     PERISTALTIC PUMP
    Isolated Perfused



                        PERISTALTIC: The Peristaltic Pump is used to transport the buffer solution from the reservoir through the
                        system and to the heart. It is important that the buffer delivery pump offer a range of flow well within the flow
                        demand of the system. The pump should be operating at a mid range of its speed capability to insure a long
                        pump life. The Peristaltic Pump provided with the Radnoti 120101BEZ Isolated Working Heart System is the
                        170100A Peristaltic Pump with Two 170110 easy load pump heads:

                        View Instruction Manual

                        Water Jacket Temperature Control: THERMAL CIRCULATING PUMP

                        THERMAL CIRCULATOR: The Thermal Circulator is used to warm and maintain temperature of the system by
                        warming the water and circulating throughout the water jacket of the system. The thermal circulator must have
                        sufficient pump strength to move the water through the system and overcome the hydrostatic pressure head
                        created by the elevated components of the system. In addition, the tank volume must be of sufficient size to
                        minimize the effect of the returning fluids’ temperature variation. The combination of these two features will insure
                        an accurate and stable temperature control throughout the system. The thermal circulator provided with the
                        Radnoti 120101BEZ Isolated Working Heart system is the 170051A Thermal Circulating Water Bath

                        View Instruction Manual



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Radnoti Glass Technology
                        Thermal Circulator Quick Setup
                        Installation
                        Locate the unit on a sturdy work area. Ambient temperatures should be inside the range of +50°F to +104°F (+10°C to +40°C).
    Isolated Perfused



                        The maximum operating relative humidity is 80%. Never place the unit in a location where excessive heat, moisture, or
                        corrosive materials are present. Make sure the voltage of the power source meets the specified voltage, ±10%. The pump
                        connections are located at the rear of the pump box and are labeled              and            These connections are angled
                        upward so the recirculating fluid will drain back into the reservoir when the hoses are disconnected. Both connections are
                        capped with stainless steel serrated plugs. The pump lines have ¼" MPT for mating with standard plumbing fittings. For your
                        Convenience, stainless steel adapters ¼" FPT to 3/8" O.D. serrated fitting are provided. The bath work area has a high and
                        low level marker to guide filling. The markers are 1 inch horizontal slits located in the center of the stainless steel baffle
                        separating the work area and the pump assembly. The correct fluid level falls between these two markers. The unit will not
                        start if the fluid level is below the lower slit.
                        Operation
                        Before starting the unit, double-check all electrical and plumbing connections. Make sure the bath is properly filled with fluid.
                        To start the unit, press           To turn the unit off press     again. The LED           indicates the status of the heater. It
                        illuminates to indicate the heater is on.
                        Temperature Adjustment
                        To display the temperature set point simply press on the controller. The          indicator will illuminate and the display will flash the
                        current set point value. To adjust the temperature set point, press the arrow buttons until the desired temperature set point is

www.radnoti.com         indicated. Press          again to confirm the change. The display will rapidly flash the new value for a short time and then return to the
 800-428-1416           recirculating fluid temperature. Please refer to the manual for periodic maintenance.
Radnoti Glass Technology
                        Peristaltic Pump Quick Setup

                                The L/S EASY-LOAD Pump Head is compatible with most MASTERFLEX® L/S® drives with a standard tang
    Isolated Perfused



                                interface. Mount the Pump Heads using the 2 long screws provided. The pump heads line up with each other
                                by the tangs and are held together with the long thumb screws.




                               Be sure the pump drive is turned off. To open the pump
                               head rotate lever to the left.
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Radnoti Glass Technology
                        Peristaltic Pump Quick Setup cont.
    Isolated Perfused




                                                  1. With the lever released, load tubing of the
                        NOTE: Tubing              correct size. Center the tubing between the
                        retainers usually do      retainers. Make sure that the tubing is in the
                        not need to be            tubing retainer slot on each side of the pump
                        readjusted when           head.
                        changing tubing of the
                        same type
                        and size.

                        NOTE: There are a
                        few combinations of                            2. Rotate the lever to the
                        tubing and materials                           right to close.
                        that may require a
                        further adjustment of
                        the tubing retainers if
                        the tubing creeps.
                        Open pump head,
                        move tubing retainer
                        down one (1) notch,
                        then close pump           3. To set the tubing retainer to the
                        head. Turn pump on.       tubing, release the retainer from the
                        If tubing creep           locked position by first pushing in
                        persists, repeat          slightly towards the body, then
                        procedure.                downward firmly against the tubing.
www.radnoti.com                                   Set retainer on both sides.
 800-428-1416
Radnoti Glass Technology
                        Water Jacket Diagram
    Isolated Perfused



                        When connecting the Water Jacketed tubing it is very important to have
                        the flow of the water go from the bottom of the component to the top.
                        Make sure that you remove all air bubbles from the components.




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Radnoti Glass Technology
                        Apical Force Measurement

                        The simplest measurement of contractile force is made using a force transducer
    Isolated Perfused



                        tied to the apex of the heart with a pulley in-between the heart and the transducer.
                        In this system a measurable amount of force is lost in a rotational motion as the
                        heart contracts, which some investigators compensate for with a three-point
                        mount.




www.radnoti.com                                                                         To Force Transducer
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Radnoti Glass Technology
                        Cardiac Pacing
                        The experimenter must decide whether the heart will be paced or
                        allowed to beat spontaneously. Pacing is used to maintain a
    Isolated Perfused



                        standard contractile response and metabolic demand. Spontaneous
                        beating may permit the experimenter to measure changes in heart
                        rate and rhythm that will occur with various drugs or manipulations.

                        To pace a heart, the stimulus rate must exceed the natural cardiac
                        pacemaker rate. Often the sinoatrial node is crushed or the right
                        atrium excised to eliminate the contribution of the primary intrinsic
                        pacemaker. Pacing voltage is determined as a set percentage
                        (normally 110-150%) above the voltage required to capture (pace)
                        the heart and should not have to exceed 3-5 v, with a duration of 0.1-
                        1 msec. Hearts may be paced using either surface or plunge
                        electrodes inserted into the cardiac tissue by running Teflon-coated
                        wires into needles, exposing the tips of the wires and bending the
                        wires over the tips of the needles. The needles are then pushed into
                        the heart and withdrawn, leaving the wire embedded in the tissue.

                        Should tissue damage be an issue, it is recommended that the
                        Radnoti Pacing Electrode be used.

                        Pacing may also be used to induce arrhythmias in attempts to
                        measure changes in fibrillation threshold.
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                        Left Ventricular Pressure

                        (In Langendorff modes only)
    Isolated Perfused




                        A saline-filled balloon catheter inserted into the left ventricle is often used to
                        measure isovolumetric work.

                        Balloons should be slightly larger than the maximum expanded
                        volume of the ventricle to avoid effects of measuring the resistance of
                        the balloon to stretch.

                        The balloon is secured to a flexible balloon catheter, which is then
                        connected to a pressure transducer. The balloon may be inserted by
                        passage through the left atrium or by passing the catheter through the wall
                        of the left ventricle for pressure measurements. In this case, a one-way
                        valve must be placed in the aortic cannula if the intraventricular pressure
                        exceeds the perfusion pressure.




www.radnoti.com
 800-428-1416           Radnoti offers a complete range of latex balloons for use in the isolated heart.
Radnoti Glass Technology
                        Working Heart Contractile Function

                        In the Working Heart Model, contractile function can be assessed by the initial
    Isolated Perfused



                        ejection pressure at the aorta. The concomitant ability to pump against an
                        afterload and/or reach a set ejection pressure with a preload is set by adjusting the
                        height of the compliance loop reservoir.

                        Pressure-volume work is determined by the total volume of fluid ejected by the          Afterload pressure
                        ventricle over time. In any of these cases, the experimenter should determine the
                        appropriate amount of resting force or pressure required to maintain the heart on
                        the ascending limb of the Starling Curve and avoid overstretching the heart
                        muscle.

                        Other useful functions derived from contractile measurements include the first
                        derivative, dP/dt, a determinant of the rate of change of developed pressure and
                        the integral of pressure as an index of work. Heart rate can be monitored from
                        force measurements or monitored independently with an ECG amplifier.




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                        Starling Curve Defined
                        The Frank-Starling law of the heart (also known as Starling's law or the Frank-Starling mechanism)
    Isolated Perfused



                        states that the more the ventricle is filled with blood during diastole (end-diastolic volume), the
                        greater the volume of ejected blood will be during the resulting systolic contraction (stroke volume).
                        There is an optimum end-diastolic volume, after which cardiac performance declines (see below).
                        This means that the force of contractions will increase as the heart is filled with more blood and is a
                        direct consequence of the effect of an increasing load on a single muscle fiber. In particular, such
                        increased load stretches the myocardium further and enhances the affinity of troponin C for
                        calcium, hence increasing the contractile force. The force that any single muscle fiber generates is
                        proportional to the initial sarcomere length (known as preload), and the stretch on the individual
                        fibers is related to the end-diastolic volume of the ventricle. In the human heart, maximal force is
                        generated with an initial sarcomere length of 2.2 micrometers, a length which is rarely exceeded in
                        the normal heart. Initial lengths larger or smaller than this optimal value will drop the force of the
                        muscle owing to less overlap of the thin and thick filaments for larger values and more overlap of the
                        thin filaments for smaller values. This can be seen most dramatically in the case of a premature
                        ventricular contraction. The premature ventricular contraction causes early emptying of the left
                        ventricle (LV) into the aorta. Since the next ventricular contraction will come at its regular time, the
                        filling time for the LV increases, causing an increased LV end diastolic volume. Because of the
                        Frank-Starling law, the next ventricular contraction will be more forceful, causing the ejection of the
                        larger than normal volume of blood, and bringing the LV end-systolic volume back to baseline.
                        For example, during vasoconstriction the end diastolic volume increases. Increasing preload will
                        increase stroke volume. The heart will pump what it receives. The above is true of healthy
                        myocardium. In the failing heart with an over-dilated ventricle, cardiac performance is compromised
www.radnoti.com         as described by Laplace's law.
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                        LVP Max Developed Pressure and Preload
                        (Balloon Method, Langendorff Only).                                        Trouble Shooting
    Isolated Perfused



                        LVP measurements are greatly affected by balloon size selection
                        and pre-load based on a Starling curve.

                        Select the appropriate balloon size.

                        It is imperative that the balloon size selected not be too small for the
                        donor heart. An indication of too small balloon size is that diastolic
                        minimum pressure is too high in order to achieve maximum developed
                        pressure.




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                        LVP Max Developed Pressure and Preload
                        (Balloon Method, Langendorff only) cont.                                  Trouble Shooting
    Isolated Perfused



                        Performing the starling curve to determine optimum preload to left
                        ventricular balloon.

                        The preload on the balloon should be increased gradually while
                        monitoring the developed pressure. An increase increment of 2mmHg
                        followed by a review of maximum developed pressure and systolic
                        pressure. Continue with the process until such time as an optimum
                        developed pressure is achieved while maintaining a physiological normal
                        systolic pressure.




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Radnoti Glass Technology
                        The Frank Starling Law of the Heart                                                   Trouble Shooting
                        The Frank-Starling Law of the Heart (also known as Starling's law or the Frank-Starling mechanism) states that the more the
    Isolated Perfused



                        ventricle is filled with blood during diastole (end-diastolic volume), the greater the volume of ejected blood will be during the
                        resulting systolic contraction (stroke volume).
                        This means that the force of contractions will increase as the heart is filled with more blood and is a direct consequence of the
                        effect of an increasing load on a single muscle fiber. In particular, such increased load stretches further the myocardium and
                        enhances the affinity of troponin C for Calcium, hence increasing the contractile force. The force that any single muscle fiber
                        generates is proportional to the initial sarcomere length (known as preload), and the stretch on the individual fibers is related to the
                        end-diastolic volume of the ventricle. In the human heart, maximal force is generated with an initial sarcomere length of 2.2
                        micrometers, (a length which is rarely exceeded in the normal heart). Initial lengths larger or smaller than this optimal value will
                        drop the force of the muscle owing to: less overlap of the thin and thick filaments for larger values, and more overlap of the thin
                        filaments for smaller values. This can be seen most dramatically in the case of a premature ventricular contraction. The premature
                        ventricular contraction causes early emptying of the left ventricle (LV) into the aorta. Since the next ventricular contraction will
                        come at its regular time, the filling time for the LV increases, causing an increased LV end diastolic volume. Because of the
                        Frank-Starling Law, the next ventricular contraction will be more forceful, causing the ejection of the larger than normal volume of
                        blood, and bringing the LV end-systolic volume back to baseline. For example, during vasoconstriction the end diastolic volume
                        increases, increasing preload. This will increase stroke volume. The heart will pump what it receives. The above is true of healthy
                        myocardium. In the failing heart, the more the myocardium is dilated, the weaker it can pump, as it then reverts to Laplace's Law.
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                        Frank Starling Curve
                                               Left Ventricular End Diastolic Pressure
    Isolated Perfused




                           Left
                        Ventricular
                         Pressure




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                        Starling Curve
                                                                     Left Ventricular End Diastolic Pressure
    Isolated Perfused




                           Left
                        Ventricular
                         Pressure




                        Following calibration and insertion of the balloon you will want to optimize the pre-load to obtain accurate max developed pressure
                        measurements. This is a combination of both the resting pressure (or systole) and max developed pressure diastole.

                        You will see a distinct pressure wave as you begin to increase pre-load to the balloon as seen in the RED trace. Gradually
                        increasing pre-load will increase end developed pressure, as shown in the GREEN trace.

                        The BLUE trace indicates the approximate pre-load and max developed pressure for a 250-300gm adult rat.

www.radnoti.com         The ORGANGE wave indicates that pre-load has increased too far. Depicted in the trace as an acceptable max developed
 800-428-1416           pressure but an abnormally systolic or pre-load pressure. This would also be an indication of a balloon size being too small for the
                        donor heart.
Radnoti Glass Technology
                        Recommended Reading
    Isolated Perfused



                        If the experimenter is not conversant with cardiovascular pharmacology and
                        physiology there are a number of excellent texts for familiarization. Besides the
                        medical physiology and pharmacology standards, there are a number of
                        specialized texts. Pharmacologic Analysis of Drug-receptor Interaction by
                        Terrence P. Kenakin (Raven Press, NY) is compact with practical emphasis on
                        isolated tissues and organs in pharmacological research.




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 800-428-1416
Radnoti Glass Technology
                        Disclaimer
    Isolated Perfused




                        These procedures and devices are intended for research and experimentation. All statements, technical information and
                        recommendations herein are based on tests and sources we believe to be reliable, but the accuracy or completeness thereof is
                        not guaranteed.


                        Before using, user shall determine the suitability of the product for its intended use, and user assumes all risk and liability
                        whatsoever in connection therewith. Neither seller nor manufacturer shall be liable in tort or in contract for any loss or damage,
                        direct, incidental, or consequential arising out of the use or the inability to use the product. No statement or recommendation
                        contained herein shall have any force or effect unless in an agreement signed by officers of seller and manufacturer.




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Instrumentation of Radnoti Working Heart - Langendorff System

  • 1. Radnoti Glass Technology The Radnoti Working Heart System Isolated Perfused Presented by: Radnoti Glass Technology, Inc. www.radnoti.com 800-428-1416 2007
  • 2. Radnoti Glass Technology Introduction Isolated Perfused The Isolated Perfused Heart System, as originated by Oscar Langendorff more than a century ago, has become a predominant technique in pharmacological and physiological research. The technique allows the examination of cardiac contractile strength (inotropic effects), heart rate (chronotropic effects) and vascular effects without the complications of an intact animal model. From its simple beginning the technique and equipment has evolved to include both constant pressure and constant flow models in a working heart mode as well as both recirculating and non recirculating modes. The Radnoti Isolated Perfused Heart System has the capacity to function in any of these configurations allowing flexibility in experimental research and design. This presentations intention is a quick reference to instrumentation of the Radnoti Isolated Working Heart System. www.radnoti.com 800-428-1416
  • 3. Radnoti Glass Technology Experimental Options There are a great number of physiological parameters that can be measured in the Isolated Perfused Heart preparation. Isolated Perfused A pressure measurement while in constant flow mode will show the resistance of the heart, indicating vasodilatation or vasoconstriction. A left ventricular pressure measurement made using a combination of pressure transducer, flexible balloon catheter and latex balloon can serve as an indicator of contractile force. Electrocardiograms (ECGs) are readily obtained using surface electrodes of monopolar, bipolar construction or needle electrodes that pierce the heart muscle and are of interest in studies involving arrhythmias. Oxygen consumption can be determined with dual oxygen electrodes, one placed in the perfusate stream entering the heart, the other monitoring the effluent leaving the coronary sinus. This effluent can be removed through the use of a peristaltic pump and then transferred to the second oxygen electrode. Similarly, ion selective electrodes can be placed in the effluent or perfusate stream or oxygenation chamber of the Radnoti Isolated Perfused Heart apparatus thus permitting measurement of pH and other cations and anions. Radiolabelled compounds can be used for metabolic studies, as well as the release or uptake of various ions or substrates. www.radnoti.com 800-428-1416 Optical studies measuring intracellular constituents have been performed on the fluorescence of endogenous or exogenous fluorescent compounds.
  • 4. Radnoti Glass Technology Instrumentation of the System Perfusion Pressure and Ejection Pressure 159905 Isolated Perfused LVP 159907 IVP transducer & Balloon or 159905 Pressure Transducer Perfusion pressure on Aortic Cannula with 170424 flexible balloon catheter and balloon (Langendorff constant flow) Ejection Pressure on stopcock of Aortic Cannula feed to Compliance loop (Working Heart) www.radnoti.com 800-428-1416
  • 5. Radnoti Glass Technology Instrumentation of the System cont. Isolated Perfused ECG #140155 ECG electrodes and ML132 Bioamp Flow- Perfusion IUF1000 Flow Meter mounted at feed to atrial cannula Ejection IUF1000 Flow Meter mounted inline on compliance loop Pacing #140157 Pacing electrodes GR-SD9 Stimulator www.radnoti.com 800-428-1416
  • 6. Radnoti Glass Technology Instrumentation of the System cont. Isolated Perfused O2 MI-730 Dip-type O2 microelectrode O2-ADPT Oxygen Adapter pH MI-410 Micro-combination pH microelectrode MV-ADPT Millivolt Adapter Flexible Balloon Catheter #170423 The balloon catheter is for ventricular insertion. It is a simple, reliable way to measure left ventricular isovolumetric Temperature www.radnoti.com pressure. BAT-12 Microprobe Thermometer 800-428-1416
  • 7. Radnoti Glass Technology Typical Values Isolated Perfused These values are obtained from a variety of sources and are displayed to demonstrate the approximate ranges of these values. Values are for adult animals. In vivo heart rate and blood pressure are taken at rest. Cation values are from serum. Left ventricular volume (LVV) is given for a balloon inserted into the left ventricle. CF (coronary flow) is given for a saline solution at 50-60 mmHg Rate Bpm BP mm/Hg Na,mM K,mM Ca,mM Mg,mM LVVml heart Heart Cat 110-140 125/70 163 4.4 1.3 0.7 0.7-2.4 2-3 Rat 330-360 129/91 140 5.7 2.6 1.1 0.1-0.2 8-10 Guinea Pig 280-300 120/170 145 7.4 2.6 1.2 0.1-0.2 5-8 R.pipens 37-60 31/21 Carp 40-78 43 Rabbit 205-220 110/73 155 4.6 3.5 1.6 0.4-0.7 2-5 www.radnoti.com 800-428-1416
  • 8. Radnoti Glass Technology Pumps Overview Perfusate or Buffer Delivery: PERISTALTIC PUMP Isolated Perfused PERISTALTIC: The Peristaltic Pump is used to transport the buffer solution from the reservoir through the system and to the heart. It is important that the buffer delivery pump offer a range of flow well within the flow demand of the system. The pump should be operating at a mid range of its speed capability to insure a long pump life. The Peristaltic Pump provided with the Radnoti 120101BEZ Isolated Working Heart System is the 170100A Peristaltic Pump with Two 170110 easy load pump heads: View Instruction Manual Water Jacket Temperature Control: THERMAL CIRCULATING PUMP THERMAL CIRCULATOR: The Thermal Circulator is used to warm and maintain temperature of the system by warming the water and circulating throughout the water jacket of the system. The thermal circulator must have sufficient pump strength to move the water through the system and overcome the hydrostatic pressure head created by the elevated components of the system. In addition, the tank volume must be of sufficient size to minimize the effect of the returning fluids’ temperature variation. The combination of these two features will insure an accurate and stable temperature control throughout the system. The thermal circulator provided with the Radnoti 120101BEZ Isolated Working Heart system is the 170051A Thermal Circulating Water Bath View Instruction Manual www.radnoti.com 800-428-1416
  • 9. Radnoti Glass Technology Thermal Circulator Quick Setup Installation Locate the unit on a sturdy work area. Ambient temperatures should be inside the range of +50°F to +104°F (+10°C to +40°C). Isolated Perfused The maximum operating relative humidity is 80%. Never place the unit in a location where excessive heat, moisture, or corrosive materials are present. Make sure the voltage of the power source meets the specified voltage, ±10%. The pump connections are located at the rear of the pump box and are labeled and These connections are angled upward so the recirculating fluid will drain back into the reservoir when the hoses are disconnected. Both connections are capped with stainless steel serrated plugs. The pump lines have ¼" MPT for mating with standard plumbing fittings. For your Convenience, stainless steel adapters ¼" FPT to 3/8" O.D. serrated fitting are provided. The bath work area has a high and low level marker to guide filling. The markers are 1 inch horizontal slits located in the center of the stainless steel baffle separating the work area and the pump assembly. The correct fluid level falls between these two markers. The unit will not start if the fluid level is below the lower slit. Operation Before starting the unit, double-check all electrical and plumbing connections. Make sure the bath is properly filled with fluid. To start the unit, press To turn the unit off press again. The LED indicates the status of the heater. It illuminates to indicate the heater is on. Temperature Adjustment To display the temperature set point simply press on the controller. The indicator will illuminate and the display will flash the current set point value. To adjust the temperature set point, press the arrow buttons until the desired temperature set point is www.radnoti.com indicated. Press again to confirm the change. The display will rapidly flash the new value for a short time and then return to the 800-428-1416 recirculating fluid temperature. Please refer to the manual for periodic maintenance.
  • 10. Radnoti Glass Technology Peristaltic Pump Quick Setup The L/S EASY-LOAD Pump Head is compatible with most MASTERFLEX® L/S® drives with a standard tang Isolated Perfused interface. Mount the Pump Heads using the 2 long screws provided. The pump heads line up with each other by the tangs and are held together with the long thumb screws. Be sure the pump drive is turned off. To open the pump head rotate lever to the left. www.radnoti.com 800-428-1416
  • 11. Radnoti Glass Technology Peristaltic Pump Quick Setup cont. Isolated Perfused 1. With the lever released, load tubing of the NOTE: Tubing correct size. Center the tubing between the retainers usually do retainers. Make sure that the tubing is in the not need to be tubing retainer slot on each side of the pump readjusted when head. changing tubing of the same type and size. NOTE: There are a few combinations of 2. Rotate the lever to the tubing and materials right to close. that may require a further adjustment of the tubing retainers if the tubing creeps. Open pump head, move tubing retainer down one (1) notch, then close pump 3. To set the tubing retainer to the head. Turn pump on. tubing, release the retainer from the If tubing creep locked position by first pushing in persists, repeat slightly towards the body, then procedure. downward firmly against the tubing. www.radnoti.com Set retainer on both sides. 800-428-1416
  • 12. Radnoti Glass Technology Water Jacket Diagram Isolated Perfused When connecting the Water Jacketed tubing it is very important to have the flow of the water go from the bottom of the component to the top. Make sure that you remove all air bubbles from the components. www.radnoti.com 800-428-1416
  • 13. Radnoti Glass Technology Apical Force Measurement The simplest measurement of contractile force is made using a force transducer Isolated Perfused tied to the apex of the heart with a pulley in-between the heart and the transducer. In this system a measurable amount of force is lost in a rotational motion as the heart contracts, which some investigators compensate for with a three-point mount. www.radnoti.com To Force Transducer 800-428-1416
  • 14. Radnoti Glass Technology Cardiac Pacing The experimenter must decide whether the heart will be paced or allowed to beat spontaneously. Pacing is used to maintain a Isolated Perfused standard contractile response and metabolic demand. Spontaneous beating may permit the experimenter to measure changes in heart rate and rhythm that will occur with various drugs or manipulations. To pace a heart, the stimulus rate must exceed the natural cardiac pacemaker rate. Often the sinoatrial node is crushed or the right atrium excised to eliminate the contribution of the primary intrinsic pacemaker. Pacing voltage is determined as a set percentage (normally 110-150%) above the voltage required to capture (pace) the heart and should not have to exceed 3-5 v, with a duration of 0.1- 1 msec. Hearts may be paced using either surface or plunge electrodes inserted into the cardiac tissue by running Teflon-coated wires into needles, exposing the tips of the wires and bending the wires over the tips of the needles. The needles are then pushed into the heart and withdrawn, leaving the wire embedded in the tissue. Should tissue damage be an issue, it is recommended that the Radnoti Pacing Electrode be used. Pacing may also be used to induce arrhythmias in attempts to measure changes in fibrillation threshold. www.radnoti.com 800-428-1416
  • 15. Radnoti Glass Technology Left Ventricular Pressure (In Langendorff modes only) Isolated Perfused A saline-filled balloon catheter inserted into the left ventricle is often used to measure isovolumetric work. Balloons should be slightly larger than the maximum expanded volume of the ventricle to avoid effects of measuring the resistance of the balloon to stretch. The balloon is secured to a flexible balloon catheter, which is then connected to a pressure transducer. The balloon may be inserted by passage through the left atrium or by passing the catheter through the wall of the left ventricle for pressure measurements. In this case, a one-way valve must be placed in the aortic cannula if the intraventricular pressure exceeds the perfusion pressure. www.radnoti.com 800-428-1416 Radnoti offers a complete range of latex balloons for use in the isolated heart.
  • 16. Radnoti Glass Technology Working Heart Contractile Function In the Working Heart Model, contractile function can be assessed by the initial Isolated Perfused ejection pressure at the aorta. The concomitant ability to pump against an afterload and/or reach a set ejection pressure with a preload is set by adjusting the height of the compliance loop reservoir. Pressure-volume work is determined by the total volume of fluid ejected by the Afterload pressure ventricle over time. In any of these cases, the experimenter should determine the appropriate amount of resting force or pressure required to maintain the heart on the ascending limb of the Starling Curve and avoid overstretching the heart muscle. Other useful functions derived from contractile measurements include the first derivative, dP/dt, a determinant of the rate of change of developed pressure and the integral of pressure as an index of work. Heart rate can be monitored from force measurements or monitored independently with an ECG amplifier. www.radnoti.com 800-428-1416
  • 17. Radnoti Glass Technology Starling Curve Defined The Frank-Starling law of the heart (also known as Starling's law or the Frank-Starling mechanism) Isolated Perfused states that the more the ventricle is filled with blood during diastole (end-diastolic volume), the greater the volume of ejected blood will be during the resulting systolic contraction (stroke volume). There is an optimum end-diastolic volume, after which cardiac performance declines (see below). This means that the force of contractions will increase as the heart is filled with more blood and is a direct consequence of the effect of an increasing load on a single muscle fiber. In particular, such increased load stretches the myocardium further and enhances the affinity of troponin C for calcium, hence increasing the contractile force. The force that any single muscle fiber generates is proportional to the initial sarcomere length (known as preload), and the stretch on the individual fibers is related to the end-diastolic volume of the ventricle. In the human heart, maximal force is generated with an initial sarcomere length of 2.2 micrometers, a length which is rarely exceeded in the normal heart. Initial lengths larger or smaller than this optimal value will drop the force of the muscle owing to less overlap of the thin and thick filaments for larger values and more overlap of the thin filaments for smaller values. This can be seen most dramatically in the case of a premature ventricular contraction. The premature ventricular contraction causes early emptying of the left ventricle (LV) into the aorta. Since the next ventricular contraction will come at its regular time, the filling time for the LV increases, causing an increased LV end diastolic volume. Because of the Frank-Starling law, the next ventricular contraction will be more forceful, causing the ejection of the larger than normal volume of blood, and bringing the LV end-systolic volume back to baseline. For example, during vasoconstriction the end diastolic volume increases. Increasing preload will increase stroke volume. The heart will pump what it receives. The above is true of healthy myocardium. In the failing heart with an over-dilated ventricle, cardiac performance is compromised www.radnoti.com as described by Laplace's law. 800-428-1416
  • 18. Radnoti Glass Technology LVP Max Developed Pressure and Preload (Balloon Method, Langendorff Only). Trouble Shooting Isolated Perfused LVP measurements are greatly affected by balloon size selection and pre-load based on a Starling curve. Select the appropriate balloon size. It is imperative that the balloon size selected not be too small for the donor heart. An indication of too small balloon size is that diastolic minimum pressure is too high in order to achieve maximum developed pressure. www.radnoti.com 800-428-1416
  • 19. Radnoti Glass Technology LVP Max Developed Pressure and Preload (Balloon Method, Langendorff only) cont. Trouble Shooting Isolated Perfused Performing the starling curve to determine optimum preload to left ventricular balloon. The preload on the balloon should be increased gradually while monitoring the developed pressure. An increase increment of 2mmHg followed by a review of maximum developed pressure and systolic pressure. Continue with the process until such time as an optimum developed pressure is achieved while maintaining a physiological normal systolic pressure. www.radnoti.com 800-428-1416
  • 20. Radnoti Glass Technology The Frank Starling Law of the Heart Trouble Shooting The Frank-Starling Law of the Heart (also known as Starling's law or the Frank-Starling mechanism) states that the more the Isolated Perfused ventricle is filled with blood during diastole (end-diastolic volume), the greater the volume of ejected blood will be during the resulting systolic contraction (stroke volume). This means that the force of contractions will increase as the heart is filled with more blood and is a direct consequence of the effect of an increasing load on a single muscle fiber. In particular, such increased load stretches further the myocardium and enhances the affinity of troponin C for Calcium, hence increasing the contractile force. The force that any single muscle fiber generates is proportional to the initial sarcomere length (known as preload), and the stretch on the individual fibers is related to the end-diastolic volume of the ventricle. In the human heart, maximal force is generated with an initial sarcomere length of 2.2 micrometers, (a length which is rarely exceeded in the normal heart). Initial lengths larger or smaller than this optimal value will drop the force of the muscle owing to: less overlap of the thin and thick filaments for larger values, and more overlap of the thin filaments for smaller values. This can be seen most dramatically in the case of a premature ventricular contraction. The premature ventricular contraction causes early emptying of the left ventricle (LV) into the aorta. Since the next ventricular contraction will come at its regular time, the filling time for the LV increases, causing an increased LV end diastolic volume. Because of the Frank-Starling Law, the next ventricular contraction will be more forceful, causing the ejection of the larger than normal volume of blood, and bringing the LV end-systolic volume back to baseline. For example, during vasoconstriction the end diastolic volume increases, increasing preload. This will increase stroke volume. The heart will pump what it receives. The above is true of healthy myocardium. In the failing heart, the more the myocardium is dilated, the weaker it can pump, as it then reverts to Laplace's Law. www.radnoti.com 800-428-1416
  • 21. Radnoti Glass Technology Frank Starling Curve Left Ventricular End Diastolic Pressure Isolated Perfused Left Ventricular Pressure www.radnoti.com 800-428-1416
  • 22. Radnoti Glass Technology Starling Curve Left Ventricular End Diastolic Pressure Isolated Perfused Left Ventricular Pressure Following calibration and insertion of the balloon you will want to optimize the pre-load to obtain accurate max developed pressure measurements. This is a combination of both the resting pressure (or systole) and max developed pressure diastole. You will see a distinct pressure wave as you begin to increase pre-load to the balloon as seen in the RED trace. Gradually increasing pre-load will increase end developed pressure, as shown in the GREEN trace. The BLUE trace indicates the approximate pre-load and max developed pressure for a 250-300gm adult rat. www.radnoti.com The ORGANGE wave indicates that pre-load has increased too far. Depicted in the trace as an acceptable max developed 800-428-1416 pressure but an abnormally systolic or pre-load pressure. This would also be an indication of a balloon size being too small for the donor heart.
  • 23. Radnoti Glass Technology Recommended Reading Isolated Perfused If the experimenter is not conversant with cardiovascular pharmacology and physiology there are a number of excellent texts for familiarization. Besides the medical physiology and pharmacology standards, there are a number of specialized texts. Pharmacologic Analysis of Drug-receptor Interaction by Terrence P. Kenakin (Raven Press, NY) is compact with practical emphasis on isolated tissues and organs in pharmacological research. www.radnoti.com 800-428-1416
  • 24. Radnoti Glass Technology Disclaimer Isolated Perfused These procedures and devices are intended for research and experimentation. All statements, technical information and recommendations herein are based on tests and sources we believe to be reliable, but the accuracy or completeness thereof is not guaranteed. Before using, user shall determine the suitability of the product for its intended use, and user assumes all risk and liability whatsoever in connection therewith. Neither seller nor manufacturer shall be liable in tort or in contract for any loss or damage, direct, incidental, or consequential arising out of the use or the inability to use the product. No statement or recommendation contained herein shall have any force or effect unless in an agreement signed by officers of seller and manufacturer. www.radnoti.com 800-428-1416