Combining transmural left ventricular mechanics and energetics to predict oxygen demand

This study relates to our earlier study which predicts the transmural distribution as well as the global left ventricular (LV) function and oxygen demand, based on the LV structure, geometry and sarcomere function. Here, we test the predicted global oxygen demand against experimental data in anesthetized, open chest dogs under changing working conditions. The experimental oxygen demand was calculated from the arterio-venous difference in oxygen content times the measured coronary flow. LV load was manipulated by a combination of a pressurized chamber connected to the femoral artery, phenylephrine infusion and an adjustable arteriovenous shunt. The heart was paced in two preset heart rates. The study demonstrates that the global predictions, based on the local distributed oxygen demand model, are comparable to those obtained by other methods of global metabolic predictions. However, unlike other global methods, the distributed model gives spatial information and predicts an endo/epi ratio of oxygen demand ranging between 1.05 to 1.14, depending on the loading conditions, which is comparable to available experimental data. For the experimental conditions studied here (stroke volume, heart rate, aortic pressure), the theoretical analysis shows that only the end diastolic volume is significantly correlated to the endo/epi ratio of the transmural oxygen demand.