Epidemiological studies have linked intra-uterine growth restriction (IUGR) with an increased risk of CVD later in life. The aim of the present study was to examine the effect of maternal protein restriction on cardiac function in adulthood during dobutamine (DOB) stimulation. IUGR was induced in Wistar Kyoto dams through administration of a low-protein diet (LPD; 8·7 % casein) during pregnancy and lactation; the control group received a normal-protein diet (NPD; 20 % casein). At 14 weeks of age, cardiac function was assessed in male and female NPD (eight females and eight males) and LPD offspring (ten females and ten males) by pressure volumetry using an anaesthetised closed-chest approach. We determined mean arterial pressure (MAP), heart rate and left ventricular pressure–volume indices under baseline conditions and DOB stimulation (2 and 4 μg/kg per min). During β-adrenergic activation in LPD offspring, increases in cardiac output (CO, P < 0·018) and stroke volume (SV, P < 0·005) were attenuated in comparison with NPD offspring, while increases in ejection fraction and the maximal rate of ventricular pressure development were not affected. LPD females maintained a smaller end-diastolic volume (P < 0·017). MAP did not differ between the groups and did not change significantly during DOB infusion. Arterial elastance and total peripheral resistance decreased in all rats but remained significantly elevated in LPD offspring (P < 0·015 and < 0·01). Early growth restriction did not affect ventricular contractility but led to an increased afterload and impaired the ability to increase SV and CO during β-adrenergic stimulation.

Cardiac and pulmonary physiology in patients with functionally univentricular hearts is markedly different from that found in the setting of the normal circulation. The physiology of both the heart and the lungs remains abnormal after palliative procedures, such as creation of systemic-to-pulmonary shunts, banding of the pulmonary trunk, or creation of the cavo-pulmonary connections. In this brief review, I will concentrate on two main aspects of physiology, namely oxygenation and haemodynamics. I will make comparisons between the normal circulation and the functionally univentricular circulation, the latter both before and after creation of a cavo-pulmonary connection. To finish, I will discuss the physiology of the cavo-pulmonary connection itself, and consider some clinical implications.

Persons at risk for hypertension may show elevated blood pressure (BP) at rest and during mental stress; however, the hemodynamics underlying the BP of those persons at high risk are not well characterized. We chose 21 high risk and 21 low risk men using their parental hypertension history and resting systolic blood pressures on two screenings. Then, on a day of extended rest versus a day with prolonged mental arithmetic and reaction time tasks, we examined whether high risk BP elevations reflected greater vascular resistance or cardiac output. High risk men had raised systolic/diastolic pressures (Fs = 74/15, ps < .0001/.0001) and higher vascular resistance (F = 6.6, p < .02) with minimal differences in heart rate and cardiac output. This finding implicates vascular resistance as the altered element in BP control in these high risk men tested in a familiar environment with minimal task-related threat.