Cargando…
Quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops
Left ventricular (LV) stroke work (SW) is calculated from the pressure-volume (PV) loop. PV loops do not contain information on longitudinal and radial pumping, leaving their contributions to SW unknown. A conceptual framework is proposed to derive the longitudinal and radial contributions to SW, us...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Physiological Society
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285573/ https://www.ncbi.nlm.nih.gov/pubmed/32816638 http://dx.doi.org/10.1152/japplphysiol.00198.2020 |
_version_ | 1783723586606858240 |
---|---|
author | Seemann, Felicia Berg, Jonathan Solem, Kristian Jablonowski, Robert Arheden, Håkan Carlsson, Marcus Heiberg, Einar |
author_facet | Seemann, Felicia Berg, Jonathan Solem, Kristian Jablonowski, Robert Arheden, Håkan Carlsson, Marcus Heiberg, Einar |
author_sort | Seemann, Felicia |
collection | PubMed |
description | Left ventricular (LV) stroke work (SW) is calculated from the pressure-volume (PV) loop. PV loops do not contain information on longitudinal and radial pumping, leaving their contributions to SW unknown. A conceptual framework is proposed to derive the longitudinal and radial contributions to SW, using ventricular force-length loops reflecting longitudinal and radial pumping. The aim of this study was to develop and validate this framework experimentally and to explore these contributions in healthy controls and heart failure patients. Thirteen swine underwent cardiovascular magnetic resonance (CMR) and LV pressure catheterization at baseline (n = 7) or 1 wk after myocardial infarction (n = 6). CMR and noninvasive PV loop quantification were performed on 26 human controls and 14 patients. Longitudinal and radial forces were calculated as LV pressure multiplied by the myocardial surface areas in the respective directions. Length components were defined as the atrioventricular plane and epicardial displacements, respectively. Contributions to SW were calculated as the area within the respective force-length loop. Summation of longitudinal and radial SW had excellent agreement with PV loop-derived SW (ICC = 0.95, R = 0.96, bias ± SD = −4.5 ± 5.4%) in swine. Longitudinal and radial contributions to SW were ~50/50% in swine and human controls, and 44/56% in patients. Longitudinal pumping required less work than radial to deliver stroke volume in swine (6.8 ± 0.8 vs. 8.7 ± 1.2 mJ/mL, P = 0.0002) and in humans (11 ± 2.1 vs. 17 ± 4.7 mJ/mL, P < 0.0001). In conclusion, longitudinal and radial pumping contribute ~50/50% to SW in swine and human controls and 44/56% in heart failure patients. Longitudinal pumping is more energy efficient than radial pumping in delivering stroke volume. NEW & NOTEWORTHY A novel method for quantifying the contributions of longitudinal and radial pumping to stroke work using global left ventricular force-length loops was proposed and validated, which can be quantified noninvasively using cardiovascular magnetic resonance and brachial cuff pressure. We found that longitudinal and radial pumping contributes equally to stroke work in controls and 44/56% in heart failure patients, and that the longitudinal pumping is more energy efficient in delivering stroke volume than radial pumping. |
format | Online Article Text |
id | pubmed-8285573 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | American Physiological Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-82855732021-07-27 Quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops Seemann, Felicia Berg, Jonathan Solem, Kristian Jablonowski, Robert Arheden, Håkan Carlsson, Marcus Heiberg, Einar J Appl Physiol (1985) Research Article Left ventricular (LV) stroke work (SW) is calculated from the pressure-volume (PV) loop. PV loops do not contain information on longitudinal and radial pumping, leaving their contributions to SW unknown. A conceptual framework is proposed to derive the longitudinal and radial contributions to SW, using ventricular force-length loops reflecting longitudinal and radial pumping. The aim of this study was to develop and validate this framework experimentally and to explore these contributions in healthy controls and heart failure patients. Thirteen swine underwent cardiovascular magnetic resonance (CMR) and LV pressure catheterization at baseline (n = 7) or 1 wk after myocardial infarction (n = 6). CMR and noninvasive PV loop quantification were performed on 26 human controls and 14 patients. Longitudinal and radial forces were calculated as LV pressure multiplied by the myocardial surface areas in the respective directions. Length components were defined as the atrioventricular plane and epicardial displacements, respectively. Contributions to SW were calculated as the area within the respective force-length loop. Summation of longitudinal and radial SW had excellent agreement with PV loop-derived SW (ICC = 0.95, R = 0.96, bias ± SD = −4.5 ± 5.4%) in swine. Longitudinal and radial contributions to SW were ~50/50% in swine and human controls, and 44/56% in patients. Longitudinal pumping required less work than radial to deliver stroke volume in swine (6.8 ± 0.8 vs. 8.7 ± 1.2 mJ/mL, P = 0.0002) and in humans (11 ± 2.1 vs. 17 ± 4.7 mJ/mL, P < 0.0001). In conclusion, longitudinal and radial pumping contribute ~50/50% to SW in swine and human controls and 44/56% in heart failure patients. Longitudinal pumping is more energy efficient than radial pumping in delivering stroke volume. NEW & NOTEWORTHY A novel method for quantifying the contributions of longitudinal and radial pumping to stroke work using global left ventricular force-length loops was proposed and validated, which can be quantified noninvasively using cardiovascular magnetic resonance and brachial cuff pressure. We found that longitudinal and radial pumping contributes equally to stroke work in controls and 44/56% in heart failure patients, and that the longitudinal pumping is more energy efficient in delivering stroke volume than radial pumping. American Physiological Society 2020-10-01 2020-08-20 /pmc/articles/PMC8285573/ /pubmed/32816638 http://dx.doi.org/10.1152/japplphysiol.00198.2020 Text en Copyright © 2020 The Authors https://creativecommons.org/licenses/by/4.0/Licensed under Creative Commons Attribution CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/) . Published by the American Physiological Society. |
spellingShingle | Research Article Seemann, Felicia Berg, Jonathan Solem, Kristian Jablonowski, Robert Arheden, Håkan Carlsson, Marcus Heiberg, Einar Quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops |
title | Quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops |
title_full | Quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops |
title_fullStr | Quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops |
title_full_unstemmed | Quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops |
title_short | Quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops |
title_sort | quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285573/ https://www.ncbi.nlm.nih.gov/pubmed/32816638 http://dx.doi.org/10.1152/japplphysiol.00198.2020 |
work_keys_str_mv | AT seemannfelicia quantificationofleftventricularcontributiontostrokeworkbylongitudinalandradialforcelengthloops AT bergjonathan quantificationofleftventricularcontributiontostrokeworkbylongitudinalandradialforcelengthloops AT solemkristian quantificationofleftventricularcontributiontostrokeworkbylongitudinalandradialforcelengthloops AT jablonowskirobert quantificationofleftventricularcontributiontostrokeworkbylongitudinalandradialforcelengthloops AT arhedenhakan quantificationofleftventricularcontributiontostrokeworkbylongitudinalandradialforcelengthloops AT carlssonmarcus quantificationofleftventricularcontributiontostrokeworkbylongitudinalandradialforcelengthloops AT heibergeinar quantificationofleftventricularcontributiontostrokeworkbylongitudinalandradialforcelengthloops |