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(Circulation. 2000;101:2185.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
From the Cardiac Muscle Research Laboratory, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Mass.
Correspondence to Niraj Varma, MRCP, Cardiac Muscle Research Laboratory X720, Boston University School of Medicine, 650 Albany St, Boston MA 02118.
BackgroundIncreased
diastolic chamber stiffness (
DCS) during angina (demand
ischemia) has been postulated to be generated by increased
diastolic myocyte calcium concentration.
Methods and ResultsWe reproduced demand ischemia in
isolated isovolumically contracting red-cellperfused rabbit hearts by
imposing pacing tachycardia during global low
coronary blood flow (32% of baseline). This increased lactate
production without increasing oxygen consumption and resulted
in
DCS (isovolumic left ventricular
end-diastolic pressure [LVEDP] increased 10 mm Hg,
P<0.001, n=38). To determine the mechanism of
DCS,
we assessed responses to a quick-stretch-release maneuver (QSR), in
which the intraventricular balloon was rapidly
inflated and deflated to achieve a 3% circumferential muscle fiber
length change. QSR was first validated as an effective method of
discriminating between calcium-driven and rigor-mediated
DCS. QSR
imposed during demand ischemia when DCS had increased (LVEDP
pretachycardia versus posttachycardia, 15±1
versus 27±2 mm Hg, P<0.001, n=6) reduced DCS to
pretachycardia values (LVEDP post-QSR, 15±1 mm Hg,
P<0.001), ie, elicited a response characteristic of
rigor, without any component of calcium-generated tension.
ConclusionsA rigor force, possibly resulting from high-energy phosphate depletion and/or an increase in ADP, appears to be the primary mechanism underlying increased DCS in this model of global LV demand ischemia.
Key Words: diastole angina rigor
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