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Am J Physiol Heart Circ Physiol 274: H945-H954, 1998;
0363-6135/98 $5.00
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Vol. 274, Issue 3, H945-H954, March 1998

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

Steven B. Solomon1,2, Srdjan D. Nikolic3, Stanton A. Glantz2, and Edward L. Yellin1

1 Departments of Cardiothoracic Surgery and Biophysics and Physiology, Albert Einstein College of Medicine, Bronx, New York 10461; 2 Cardiovascular Research Institute and Department of Medicine, University of California, San Francisco 94143; and 3 Department of Cardiovascular and Thoracic Surgery, Research Institute of the Palo Alto Medical Foundation, Stanford University School of Medicine, Palo Alto, California 94306

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 transmitral 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.

cardiac mechanics; restrictive pattern of filling; elastic recoil


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