AJP - Heart Ad Instruments
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Am J Physiol Heart Circ Physiol 279: H1120-H1127, 2000;
0363-6135/00 $5.00
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (13)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Segers, P.
Right arrow Articles by Westerhof, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Segers, P.
Right arrow Articles by Westerhof, N.
Vol. 279, Issue 3, H1120-H1127, September 2000

Left ventricular wall stress normalization in chronic pressure-overloaded heart: a mathematical model study

Patrick Segers1, Nikos Stergiopulos2, Jan J. Schreuder3, Berend E. Westerhof4, and Nico Westerhof1

1 Laboratory for Physiology, Institute for Cardiovascular Research, Free University of Amsterdam, and 4 Biomedical Instrumentation, Institute of Applied Physics, Netherlands Organization for Applied Scientific Research, Academic Medical Center, 1081 BT Amsterdam, The Netherlands; 2 Biomedical Engineering Laboratory, Ecole Polytechnique Fédéralé de Lausanne, 1015 Lausanne, Switzerland; and 3 Department of Cardiac Surgery, Ospedale San Raffaele, 20132 Milan, Italy

It is generally accepted that the left ventricle (LV) hypertrophies (LVH) to normalize systolic wall stress (sigma s) in chronic pressure overload. However, LV filling pressure (Pv) may be elevated as well, supporting the alternative hypothesis of end-diastolic wall stress (sigma d) normalization in LVH. We used an LV time-varying elastance model coupled to an arterial four-element lumped-parameter model to study ventricular-arterial interaction in hypertension-induced LVH. We assessed model parameters for normotensive controls and applied arterial changes as observed in hypertensive patients with LVH (resistance +40%, compliance -25%) and assumed 1) no cardiac adaptation, 2) normalization of sigma s by LVH, and 3) normalization of sigma s by LVH and increase in Pv, such that sigma d is normalized as well. In patients, systolic and diastolic blood pressures increase by ~40%, cardiac output (CO) is constant, and wall thickness increases by 30-55%. In scenarios 1 and 2, blood pressure increased by only 10% while CO dropped by 20%. In scenario 2, LV wall thickness increased by only 10%. The predictions of scenario 3 were in qualitative and quantitative agreement with in vivo human data. LVH thus contributes to the elevated blood pressure in hypertension, and cardiac adaptations include an increase in Pv, normalization of sigma s, and preservation of CO in the presence of an impaired diastolic function.

hypertrophy; heart-arterial interaction; aging; hypertension; varying elastance; windkessel; left ventricle


This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
C. Mekkaoui, P. H. Rolland, A. Friggi, M. Rasigni, and T. G. Mesana
Pressure-flow loops and instantaneous input impedance in the thoracic aorta: Another way to assess the effect of aortic bypass graft implantation on myocardial, brain, and subdiaphragmatic perfusion
J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 699 - 710.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
P. Segers, H. A. Leather, P. Verdonck, Y.-Y. Sun, and P. F. Wouters
Preload-adjusted maximal power of right ventricle: contribution of end-systolic P-V relation intercept
Am J Physiol Heart Circ Physiol, October 1, 2002; 283(4): H1681 - H1687.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
P. Segers, N. Stergiopulos, and N. Westerhof
Relation of effective arterial elastance to arterial system properties
Am J Physiol Heart Circ Physiol, March 1, 2002; 282(3): H1041 - H1046.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Visit Other APS Journals Online