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Cardiology and Nephrology Sections, Department of Medicine, University of Chicago, Chicago, Illinois 60637
Effects of
acidosis on muscle contractile function have been studied extensively.
However, the relative effects of different types of extracellular
acidosis on left ventricular (LV) contractile function, especially the
temporal features of contraction, have not been investigated in a
single model. We constituted perfusion buffers of identical ionic
composition, including Ca2+
concentration
([Ca2+]), to mimic
physiological control condition (pH 7.40) and three types of acidosis
with pH of 7.03: inorganic (IA), respiratory (RA), and lactic (LA).
Isolated rabbit hearts (n = 9) were
perfused with acidotic buffers chosen at random, each preceded by the
control buffer. Under steady-state conditions, instantaneous LV
pressure (Pv) and volume
(Vv) were recorded for a range
of Vv. The results were as
follows. 1) LV passive
(end-diastolic) elastance increased with IA and RA. However, this
increase may not be a direct effect of acidosis; it can be explained on
the basis of myocardial turgor. 2)
Although LV inotropic state (peak active
Pv and elastance) was depressed by
all three acidotic buffers, the magnitude of inotropic depression was
significantly less for LA. 3)
Temporal features of Pv were
altered differently. Whereas IA and RA reduced time to peak
Pv
(tmax) and
hastened isovolumic relaxation at a common level of LV wall stress, LA
significantly increased
tmax and retarded
relaxation. These results and a model-based interpretation suggest that
cooperative feedback (i.e., force-activation interaction) plays an
important role in acidosis-induced changes in LV contractile function.
Furthermore, it is proposed that LA-induced responses comprise two
components, one due to intracellular acidosis and the other due to
pH-independent effects of lactate ions.
pH; left ventricular inotropic state; left ventricular relaxation; cooperative feedback; activation-cross bridge dynamics; lactate ion
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