Document Detail


Clinical correlates of the myocardial force-frequency relationship in patients with end-stage heart failure.
MedLine Citation:
PMID:  9402516     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study tested the hypothesis that in patients with suspected heart failure, peak oxygen consumption was the best predictor of heart muscle failure. Failing human myocardium is characterized by an abnormal force-frequency relationship, which has been previously shown to be altered in parallel with the severity of heart failure. METHODS: We examined whether seven different functional parameters of isolated electrically driven ventricular trabeculae carneae obtained from 34 explanted hearts of patients undergoing heart transplantation for end-stage heart failure correlated with any of 47 separate pretransplantation clinical parameters. The functional muscle parameters were active force at 0.33 Hz, time to 80% relaxation (RT 80%) of twitch force at 0.33 Hz, optimal frequency (OF), active force at 1.0 Hz (AF1), diastolic force at 1.0 Hz (DF1), active force at 2.0 Hz (AF2), and diastolic force at 2.0 Hz (DF2). RESULTS: Before transplantation the mean left ventricular ejection fraction was 21% +/- 10%, and all patients were in New York Heart Association class III or IV. Mean peak whole body VO2 was 10.9 +/- 3.3 ml/min/kg and percent body mass/age/sex-adjusted maximum VO2 oxygen consumption was 34.7% +/- 10.4%. Univariate analysis of VO2 yielded the following significant correlations: active force at 33 Hz, RT80%, OF, AF1, DF1, AF2, DF2; whereas univariate analysis of percent body mass/age/sex-adjusted VO2 yielded the following significant correlations: RT80%, OF, DF1, AF2, DF2. Multivariate analysis showed that OF and DF1 were independent predictors of peak VO2. CONCLUSION: In this study we show that peak oxygen uptake measured during cardiopulmonary exercise testing obtained before transplantation is correlated with the force-frequency behavior of isolated muscles at the time of transplantation. Peak VO2 seems to be a strong indicator of the severity of cardiac contractile dysfunction in patients with heart failure.
Authors:
R J Hajjar; T G DiSalvo; U Schmidt; G Thaiyananthan; M J Semigran; G W Dec; J K Gwathmey
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  16     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-03-06     Completed Date:  1998-03-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1157-67     Citation Subset:  IM    
Affiliation:
Cardiac Unit, Massachusetts General Hospital, Boston, USA.
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MeSH Terms
Descriptor/Qualifier:
Female
Heart / physiopathology*
Heart Failure / physiopathology*
Heart Transplantation
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Contraction / physiology
Oxygen Consumption / physiology
Stroke Volume / physiology
Grant Support
ID/Acronym/Agency:
R01 HL 49574/HL/NHLBI NIH HHS; R44 HL 52249/HL/NHLBI NIH HHS

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