| Failure of myocardial inactivation: a clinical assessment in the hypertrophied heart. | |
| | |
MedLine Citation:
|
PMID: 1284368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Abnormal intracellular calcium handling is observed in hypertrophied cardiac muscle and in end-stage heart failure muscle. This abnormal calcium handling results in prolongation of the calcium transient and in a biphasic calcium transient with prominent late component. In the present studies, the mechanical correlates of abnormal calcium handling were investigated in the hypertrophied human left ventricle by analysis of: 1) isovolumic left-ventricular relaxation kinetics after drastic left-ventricular unloading in patients with severe aortic stenosis after sequential balloon aortic valvuloplasty-arterial vasodilation; and 2) morphology of the diastolic left-ventricular pressure signal in patients with aortic stenosis and hypertrophic cardiomyopathy. METHODS AND RESULTS: Drastic left-ventricular unloading in patients with severe aortic stenosis by sequential aortic valvuloplasty-arterial vasodilation resulted in a slow and dyssynchronous left-ventricular relaxation pattern, as evident from a prolongation of the time constant of left-ventricular pressure decay from 46.6 +/- 12.5 to 73.2 +/- 23.3 ms (p < 0.01), and from the development of a convex downward negative dP/dt upstroke pattern. Abnormal diastolic left-ventricular pressure wave forms consisting of continuous left-ventricular pressure decay throughout diastole and/or a secondary pressure rise in mid-diastole were observed in patients with aortic stenosis and with hypertrophic cardiomyopathy. Postextrasystolic potentiation caused further slowing of this abnormal diastolic left-ventricular pressure decay, as evident from the decrease in phase of the first harmonic of a Fourier transform applied to the diastolic left-ventricular pressure wave. When an abnormal diastolic left-ventricular pressure wave form was observed at rest or after postextrasystolic potentiation, a simultaneously recorded left-ventricular monophasic action potential signal revealed the occurrence of delayed afterdepolarizations. CONCLUSIONS: The mechanical correlates of abnormal calcium handling or of inactivation failure in the hypertrophied human left ventricle consist of slow and dyssynchronous left-ventricular isovolumic relaxation after left-ventricular unloading and of diastolic left-ventricular aftercontractions, which hinder left-ventricular filling and which are accompanied by delayed afterdepolarizations. |
| | |
Authors:
|
W J Paulus; M A Goethals; S U Sys |
Related Documents
:
|
7148648 - Left ventricular systolic and diastolic function in hyperthyroidism. 12114098 - Right ventricular diastolic dysfunction in arterial systemic hypertension: analysis by ... 11175078 - Automatic border detection for assessment of left ventricular diastolic function among ... 10372168 - Assessment of left ventricular systolic function and diastolic time intervals by the bi... 3946208 - Comparison of risk factors in vasospastic angina without significant fixed coronary nar... 16798648 - Regression of myocardial dysfunction after switching from desferrioxamine to deferipron... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Basic research in cardiology Volume: 87 Suppl 2 ISSN: 0300-8428 ISO Abbreviation: Basic Res. Cardiol. Publication Date: 1992 |
Date Detail:
|
Created Date: 1993-05-11 Completed Date: 1993-05-11 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0360342 Medline TA: Basic Res Cardiol Country: GERMANY |
Other Details:
|
Languages: eng Pagination: 145-61 Citation Subset: IM |
Affiliation:
|
Cardiovascular Center, O.L.V. Ziekenhuis, Aalst, Belgium. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Action Potentials Aged Aortic Valve Stenosis / physiopathology Calcium / metabolism Cardiac Complexes, Premature / physiopathology Cardiomegaly / metabolism, physiopathology* Diastole Heart / physiopathology* Heart Ventricles Humans Kinetics Middle Aged Myocardial Contraction Myocardium / metabolism Pressure Ventricular Function, Left |
| Chemical | |
Reg. No./Substance:
|
7440-70-2/Calcium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Histamine secretion from human mesenteric and adenoidal mast cells.
Next Document: Growth factors, growth factor response elements, and the cardiac phenotype.