Document Detail

Left ventricular diastolic function of remodeled myocardium in dogs with pacing-induced heart failure.
MedLine Citation:
PMID:  9530208     Owner:  NLM     Status:  MEDLINE    
In patients with heart failure, decreased contractility resulting in high end-diastolic pressures and a restrictive pattern of left ventricular filling produces a decrease in early diastolic filling, suggesting a stiff ventricle. This study investigated the elastic properties of the myocardium and left ventricular chamber and the ability of the heart to utilize elastic recoil to facilitate filling during pacing-induced heart failure in the anesthetized dog. Elastic properties of the myocardium were determined by analyzing the myocardial stress-strain relation. Left ventricular chamber properties were determined by analyzing the pressure-volume relation using a logarithmic approach. Elastic recoil was characterized using a computer-controlled mitral valve occluder to prevent transmittral flow during diastole. We conclude that, during heart failure, the high end-diastolic pressures suggestive of a stiff ventricle are due not to stiffer myocardium but to a ventricle whose chamber compliance characteristics are changed due to geometric remodeling of the myocardium. The restrictive filling pattern is a result of the ventricle being forced to operate on the stiff portion of the diastolic pressure-volume relation to maintain cardiac output. Slowed relaxation and decreased contractility result in an inability of the heart to contract to an end-systolic volume below its diastolic equilibrium volume. Thus the left ventricle cannot utilize elastic recoil to facilitate filling during heart failure.
S B Solomon; S D Nikolic; S A Glantz; E L Yellin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of physiology     Volume:  274     ISSN:  0002-9513     ISO Abbreviation:  Am. J. Physiol.     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-04-14     Completed Date:  1998-04-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370511     Medline TA:  Am J Physiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  H945-54     Citation Subset:  IM    
Department of Cardiothoracic Surgery, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
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MeSH Terms
Heart / physiopathology*
Heart Failure / physiopathology*
Heart Rate
Heart Valve Diseases / physiopathology
Mitral Valve
Myocardial Contraction

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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