title: Effect of reduced aortic compliance on cardiac efficiency and contractile function of in situ canine left ventricle.
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 (MVO2). 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 MVO2-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 less than 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, MVO2 increased by 32% (p less than 0.01) and was matched by a rise in PV area, such that the MVO2-PV area relation and efficiency was unaltered. The MVO2 required to sustain a given stroke volume, however, increased from 20% to 40%, depending on the baseline level (p less than 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.
authors.affiliation: Department of Internal Medicine, Johns Hopkins Medical Institutions, Baltimore, Md 21205.
authors.forename: R P
authors.initials: RP
authors.lastname: Kelly
authors.forename: R
authors.initials: R
authors.lastname: Tunin
authors.forename: D A
authors.initials: DA
authors.lastname: Kass
mesh_terms: D000375:Aging; D000818:Animals; D001011:Aorta / Q000502:physiology*; D001018:Aortic Diseases / Q000503:physiopathology; D004195:Disease Models, Animal; D004285:Dogs; D004548:Elasticity; D006801:Humans; D009200:Myocardial Contraction; D010101:Oxygen Consumption; D011093:Polyethylene Terephthalates; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D011093:Polyethylene Terephthalates