Stress-shortening relations and myocardial blood flow in compensated and failing canine hearts with pressure-overload hypertrophy

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Circulation. 1989;79:872-883

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ARTICLES

Stress-shortening relations and myocardial blood flow in compensated and failing canine hearts with pressure-overload hypertrophy

WH Gaasch, MR Zile, PK Hoshino, CS Apstein and AS Blaustein
Department of Medicine (Cardiology), Medical Center of Central Massachusetts/Memorial, Worcester 01605.

Serial changes in left ventricular (LV) size and function during the adaptation to chronic pressure overload and the transition to pump failure were studied in 16 conscious dogs (aortic bands placed at 8 weeks of age). Echocardiographic data at baseline and at 3, 6, 9, and 12 months after banding revealed a progressive increase in LV mass in all dogs. In six dogs with LV pump failure, there was a progressive decline in circumferential fiber shortening (29 +/- 4% at 12 months); this was significantly less than that seen in five littermate controls (38 +/- 3%, p less than 0.05). The average LV to body weight ratio in this group was 9.8 +/- 2.7 g/kg. In 10 dogs without pump failure (compensated LVH group), shortening exceeded that seen in the controls (43 +/- 4%, p less than 0.05); the LV to body weight ratio was 7.7 +/- 1.0 g/kg. At 12 months (cardiac catheterization), the LV end-diastolic pressure was higher in the failure (25 +/- 15 mm Hg) than in the compensated group (8 +/- 5 mm Hg, p less than 0.05); mean systolic stress was also higher in the failure group (313 +/- 67 g/cm2) than in the compensated group (202 +/- 53 g/cm2, p less than 0.05). The transmural distribution of myocardial blood flow was measured (at 12 months) with the radioactive microsphere technique; flow data were then related to an index of demand (a stress-time index). There was preferential blood flow to the subendocardial layers in the control (endo/epi = 1.28) and compensated hearts (endo/epi = 1.10), but in the failure group there was a relative decrease in subendocardial flow (endo/epi = 0.92). However, the absolute values for subendocardial flow in the normal, compensated, and failure groups were 77 +/- 54, 125 +/- 48, and 113 +/- 64 ml/min/100 g; the stress-time indexes in the subendocardial shell were 38 +/- 11, 74 +/- 19, and 93 +/- 34 g sec.10(2)/cm2/min. Despite what appears to be a marginal balance between blood flow and the stress time index in the failure group, the myocardial high energy phosphates were not depleted and the inoptropic state was not depressed. In this model of LV hypertrophy, the observed differences in fiber shortening can be explained on the basis of the inverse afterload-shortening relation; pump failure was due to an inadequate LV hypertrophy with afterload excess.(ABSTRACT TRUNCATED AT 400 WORDS)

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				J. E. Liu, D. C. Robbins, V. Palmieri, J. N. Bella, M. J. Roman, R. Fabsitz, B. V. Howard, T. K. Welty, E. T. Lee, and R. B. Devereux Association of albuminuria with systolic and diastolic left ventricular dysfunction in type 2 diabetes: The Strong Heart Study J. Am. Coll. Cardiol., June 4, 2003; 41(11): 2022 - 2028. [Abstract] [Full Text] [PDF]

				P. M. Okin, R. B. Devereux, R. R. Fabsitz, E. T. Lee, J. M. Galloway, and B. V. Howard Quantitative assessment of electrocardiographic strain predicts increased left ventricular mass: the strong heart study J. Am. Coll. Cardiol., October 16, 2002; 40(8): 1395 - 1400. [Abstract] [Full Text] [PDF]

				S. Yuda, V. Khoury, and T. H. Marwick Influence of wall stress and left ventricular geometry on the accuracy of dobutamine stress echocardiography J. Am. Coll. Cardiol., October 2, 2002; 40(7): 1311 - 1319. [Abstract] [Full Text] [PDF]

				K. Wachtell, V. Palmieri, M. H. Olsen, E. Gerdts, V. Papademetriou, M. S. Nieminen, G. Smith, B. Dahlof, G. P. Aurigemma, and R. B. Devereux Change in Systolic Left Ventricular Performance After 3 Years of Antihypertensive Treatment: The Losartan Intervention for Endpoint (LIFE) Study Circulation, July 9, 2002; 106(2): 227 - 232. [Abstract] [Full Text] [PDF]

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				G. R. Norton, A. J. Woodiwiss, W. H. Gaasch, T. Mela, E. S. Chung, G. P. Aurigemma, and T. E. Meyer Heart failure in pressure overload hypertrophy: The relative roles of ventricularremodeling and myocardial dysfunction J. Am. Coll. Cardiol., February 20, 2002; 39(4): 664 - 671. [Abstract] [Full Text] [PDF]

				D. Schultz, X. Su, C.-C. Wei, S. P. Bishop, P. Powell, G. H. Hankes, A. R. Dillon, P. Rynders, F. G. Spinale, G. Walcott, et al. Downregulation of ANG II receptor is associated with compensated pressure-overload hypertrophy in the young dog Am J Physiol Heart Circ Physiol, February 1, 2002; 282(2): H749 - H756. [Abstract] [Full Text] [PDF]

				D. K. Arnett, R. B. Devereux, D. Kitzman, A. Oberman, P. Hopkins, L. Atwood, A. Dewan, and D. C. Rao Linkage of Left Ventricular Contractility to Chromosome 11 in Humans: The HyperGEN Study Hypertension, October 1, 2001; 38(4): 767 - 772. [Abstract] [Full Text] [PDF]

				R. B. Devereux, J. N. Bella, V. Palmieri, A. Oberman, D. W. Kitzman, P. N. Hopkins, D.C. Rao, D. Morgan, M. Paranicas, D. Fishman, et al. Left Ventricular Systolic Dysfunction in a Biracial Sample of Hypertensive Adults: The HyperGEN Study Hypertension, September 1, 2001; 38(3): 417 - 423. [Abstract] [Full Text] [PDF]

				J. N. Bella, V. Palmieri, J. E. Liu, D. W. Kitzman, A. Oberman, S. C. Hunt, P. N. Hopkins, D.C. Rao, D. K. Arnett, and R. B. Devereux Relationship Between Left Ventricular Diastolic Relaxation and Systolic Function in Hypertension: The Hypertension Genetic Epidemiology Network (HyperGEN) Study Hypertension, September 1, 2001; 38(3): 424 - 428. [Abstract] [Full Text] [PDF]

				P. M. Okin, R. B. Devereux, M. S. Nieminen, S. Jern, L. Oikarinen, M. Viitasalo, L. Toivonen, S. E. Kjeldsen, S. Julius, B. Dahlof, et al. Relationship of the electrocardiographic strain pattern to left ventricular structure and function in hypertensive patients: the LIFE study J. Am. Coll. Cardiol., August 1, 2001; 38(2): 514 - 520. [Abstract] [Full Text] [PDF]

				J. E. Liu, V. Palmieri, M. J. Roman, J. N. Bella, R. Fabsitz, B. V. Howard, T. K. Welty, E. T. Lee, and R. B. Devereux The impact of diabetes on left ventricular filling pattern in normotensive and hypertensive adults: the strong heart study J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1943 - 1949. [Abstract] [Full Text] [PDF]

				D. J. Slotwiner, R. B. Devereux, J. E. Schwartz, T. G. Pickering, G. de Simone, and M. J. Roman Relation of Age to Left Ventricular Function and Systemic Hemodynamics in Uncomplicated Mild Hypertension Hypertension, June 1, 2001; 37(6): 1404 - 1409. [Abstract] [Full Text] [PDF]

				V. Palmieri, J. N. Bella, D. K. Arnett, M. J. Roman, A. Oberman, D. W. Kitzman, P. N. Hopkins, M. Paranicas, D. C. Rao, and R. B. Devereux Aortic Root Dilatation at Sinuses of Valsalva and Aortic Regurgitation in Hypertensive and Normotensive Subjects : The Hypertension Genetic Epidemiology Network Study Hypertension, May 1, 2001; 37(5): 1229 - 1235. [Abstract] [Full Text] [PDF]

				G. P. Aurigemma, J. S. Gottdiener, L. Shemanski, J. Gardin, and D. Kitzman Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: The Cardiovascular Health Study J. Am. Coll. Cardiol., March 15, 2001; 37(4): 1042 - 1048. [Abstract] [Full Text] [PDF]

				M. R. Zile, G. R. Green, G. T. Schuyler, G. P. Aurigemma, D. C. Miller, and G. Cooper IV Cardiocyte cytoskeleton in patients with left ventricular pressure overload hypertrophy J. Am. Coll. Cardiol., March 15, 2001; 37(4): 1080 - 1084. [Abstract] [Full Text] [PDF]