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Articles in PresS, published online ahead of print December 13, 2001
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00782.2001
Submitted on August 30, 2001
Accepted on December 6, 2001
1 Cardiology, Leiden University Medical Center, Leiden, Netherlands; Pediatric Cardiology, Leiden University Medical Center, Leiden, Netherlands
2 Cardiology, Leiden University Medical Center, Leiden, Netherlands
3 Pediatric Cardiology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
* To whom correspondence should be addressed. E-mail: J.Baan{at}LUMC.nl.
Diastolic function is a major determinant of ventricular performance, especially when loading conditions are altered. We evaluated biventricular diastolic function in lambs and studied possible load-dependency of several diastolic parameters (dP/dtMin and tau) in normal (n=5) and chronic right ventricular (RV) pressure overloaded hearts (n=5) using an adjustable band on the pulmonary artery (PAB). Pressure-volume relations were measured during preload reduction to obtain the end-diastolic pressure-volume relationship (EDPVR). In normal lambs, absolute dP/dtMin and tau were lower in the RV than in the LV while the chamber stiffness constant (b) was roughly the same. After PAB, RV tau and dP/dtMin were significantly higher compared to control. The RV-EDPVR indicated impaired diastolic function. During acute pressure reduction, both dP/dtMin and tau showed a relationship with end-systolic pressure. These relationships could explain the increased dP/dtMin- but not the increased tau-value after banding. Therefore, the increased tau after banding reflects intrinsic myocardial changes. We conclude that after chronic RV pressure overload, RV early relaxation is prolonged and diastolic stiffness is increased, both indicative of impaired diastolic function.
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