Document Detail


Stroke volume-to-wall stress ratio as a load-adjusted and stiffness-adjusted indicator of ventricular systolic performance in chronic loading.
MedLine Citation:
PMID:  22923502     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Load-adjusted measures of left ventricle (LV) systolic performance are limited by dependence on LV stiffness and afterload. To our knowledge, no stiffness-adjusted and afterload-adjusted indicator was tested in models of pressure (POH) and volume overload hypertrophy (VOH). We hypothesized that wall stress reflects changes in loading, incorporating chamber stiffness and afterload; therefore, stroke volume-to-wall stress ratio more accurately reflects systolic performance. We used rat models of POH (ascending aortic banding) and VOH (aorto-cava shunt). Animals underwent echocardiography and pressure-volume analysis at baseline and dobutamine challenge. We achieved extreme bidirectional alterations in LV systolic performance, end-systolic elastance (Ees), passive stiffness, and arterial elastance (Ea). In POH with LV dilatation and failure, some load-independent indicators of systolic performance remained elevated compared with controls, while some others failed to decrease with wide variability. In VOH, most, but not all indicators, including LV ejection fraction, were significantly reduced compared with controls, despite hyperdynamic circulation, lack of heart failure, and preserved contractile reserve. We related systolic performance to Ees adjusted for Ea and LV passive stiffness in multivariate models. Calculated residual Ees was not reduced in POH with heart failure and was reduced in VOH, while it positively correlated to dobutamine dose. Conversely, stroke volume-to-wall stress ratio was normal in compensated POH, markedly decreased in POH with heart failure, and, in contrast with LV ejection fraction, normal in VOH. Our results support stroke volume-to-wall stress ratio as a load-adjusted and stiffness-adjusted indicator of systolic function in models of POH and VOH.
Authors:
Elie R Chemaly; Antoine H Chaanine; Susumu Sakata; Roger J Hajjar
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-08-23
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  113     ISSN:  1522-1601     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-16     Completed Date:  2013-06-17     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1267-84     Citation Subset:  IM    
Affiliation:
Cardiovascular Research Center, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Arteries / drug effects,  physiology,  physiopathology
Body Weight / drug effects,  physiology
Dobutamine / pharmacology
Echocardiography / methods
Heart / drug effects,  physiology*
Heart Failure / physiopathology
Heart Rate / drug effects,  physiology
Heart Ventricles / drug effects,  physiopathology
Hemodynamics / drug effects,  physiology
Hypertrophy, Left Ventricular / physiopathology
Male
Pressure
Rats
Rats, Sprague-Dawley
Stroke / physiopathology
Stroke Volume / drug effects,  physiology*
Systole / drug effects,  physiology*
Ventricular Function, Left / drug effects,  physiology
Grant Support
ID/Acronym/Agency:
HL071763/HL/NHLBI NIH HHS; HL080498/HL/NHLBI NIH HHS; HL083156/HL/NHLBI NIH HHS; HL088434/HL/NHLBI NIH HHS; NIH-T32-HL007824/HL/NHLBI NIH HHS; P20HL100396/HL/NHLBI NIH HHS; R01 HL093183/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine
Comments/Corrections

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