Effect of Reduced Aortic Compliance on Cardiac Efficiency and Contractile Function of In Situ Canine Left Ventricle
作者:
Raymond Kelly,
Richard Tunin,
David Kass,
期刊:
Circulation Research
(OVID Available online 1992)
卷期:
Volume 71,
issue 3
页码: 490-502
ISSN:0009-7330
年代: 1992
出版商: OVID
关键词: aortic input impedance;ventriculovascular coupling;myocardial energetics;pressure-volume relations;ventricular function
数据来源: OVID
摘要:
This study tests the hypothesis that arterial vascular stiffening adversely influences in situ left ventricular contractile function and energetic efficiency. Ten reflex-blocked anesthetized dogs underwent a bypass operation in which a Dacron graft was sewn to the ascending aorta and connected to the infrarenal abdominal aorta via a plastic conduit. Flow was directed through either native aorta or plastic conduit by placement of vascular clamps. Arterial properties were measured from aortic pressure-flow data, and ventricular function was assessed by pressure-volume (PV) relations. Coronary sinus blood was drained via an extracorporeal circuit for direct measurement of myocardial O2consumption (MVo2). Data at multiple steady-state preload volumes were combined to derive chamber function and energetics relations. Energetic efficiency was assessed by the inverse slope of the MVO2-PV area relation. Directing flow through plastic versus native aorta resulted in a 60–80% reduction in compliance but little change in mean resistance. Arterial pulse pressure rose from 34 to 99 mm Hg (p<0.001). Contractile function assessed by the end-systolic PV relation, stroke work-end-diastolic volume relation, and dP/dtmaxat matched end-diastolic volume did not significantly change. However, MVo2increased by 32% (p<O.O1) and was matched by a rise in PV area, such that the MVO2-PV area relation and efficiency was unaltered. The MVO2required to sustain a given stroke volume, however, increased from 20% to 40%, depending on the baseline level (p<0.001). Thus, whereas the contractile function and efficiency of normal hearts are not altered by ejection into a stiff vascular system, the energetic cost to the heart for maintaining adequate flow is increased. This suggests a mechanism whereby human vascular stiffening may yield little functional decrement at rest but limit reserve capacity under conditions of increased demand.
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