Left ventricular diastolic function of remodeled myocardium in dogs with pacing-induced heart failure

Am J Physiol. 1998 Mar;274(3):H945-54. doi: 10.1152/ajpheart.1998.274.3.H945.

Abstract

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.

MeSH terms

  • Animals
  • Diastole
  • Dogs
  • Echocardiography
  • Elasticity
  • Heart / physiopathology*
  • Heart Failure / physiopathology*
  • Heart Rate
  • Heart Valve Diseases / physiopathology
  • Hemodynamics
  • Mitral Valve
  • Myocardial Contraction