Effect of reduced aortic compliance on cardiac efficiency and contractile function of in situ canine left ventricle

Raymond P. Kelly, Richard Tunin, David A. Kass

Research output: Contribution to journalArticlepeer-review

Abstract

This study tests the hypothesis that arterial vascular stiffening adversely influences in situ left ventricular contractile function and energetic efficiency. Ten reflex-blocked anesthetized dogs underwent a bypass operation in which a Dacron graft was sewn to the ascending aorta and connected to the infrarenal abdominal aorta via a plastic conduit. Flow was directed through either native aorta or plastic conduit by placement of vascular clamps. Arterial properties were measured from aortic pressure-flow data, and ventricular function was assessed by pressure-volume (PV) relations. Coronary sinus blood was drained via an extracorporeal circuit for direct measurement of myocardial O2 consumption (MV̇o2). Data at multiple steady-state preload volumes were combined to derive chamber function and energetics relations. Energetic efficiency was assessed by the inverse slope of the MV̇o2-PV area relation. Directing flow through plastic versus native aorta resulted in a 60-80% reduction in compliance but little change in mean resistance. Arterial pulse pressure rose from 34 to 99 mm Hg (p<0.001). Contractile function assessed by the end-systolic PV relation, stroke work-end-diastolic volume relation, and dP/dtmax at matched end-diastolic volume did not significantly change. However, MV̇o2 increased by 32% (p<0.01) and was matched by a rise in PV area, such that the MV̇o2-PV area relation and efficiency was unaltered. The MV̇o2 required to sustain a given stroke volume, however, increased from 20% to 40%, depending on the baseline level (p<0.001). Thus, whereas the contractile function and efficiency of normal hearts are not altered by ejection into a stiff vascular system, the energetic cost to the heart for maintaining adequate flow is increased. This suggests a mechanism whereby human vascular stiffening may yield little functional decrement at rest but limit reserve capacity under conditions of increased demand.

Original languageEnglish (US)
Pages (from-to)490-502
Number of pages13
JournalCirculation research
Volume71
Issue number3
DOIs
StatePublished - Sep 1992

Keywords

  • Aortic input impedance
  • Myocardial energetics
  • Pressure-volume relations
  • Ventricular function
  • Ventriculovascular coupling

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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