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Am J Physiol Heart Circ Physiol (January 25, 2008). doi:10.1152/ajpheart.00990.2007
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Submitted on August 27, 2007
Accepted on January 22, 2008

The physical determinants of left ventricular isovolumic pressure decline: Model-based prediction with in-vivo validation

Charles S Chung1 and Sandor J. Kovacs2*

1 Physics, Washington University, St. Louis, Missouri, United States; Cardiovascular Biophysics Laboratory, Cardiovascular Division, Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, United States
2 Physics, Washington University in St. Louis, St. Louis, Missouri, United States; Cardiovascular Biophysics Laboratory, Cardiovascular Division, Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, United States

* To whom correspondence should be addressed. E-mail: sjk{at}wuphys.wustl.edu.

The rapid decline in pressure during isovolumic relaxation (IVR) is traditionally fit algebraically via two empiric indexes, {tau}, the 'time-constant of IVR', or a logistic time constant (τL). Although these indexes are used for in-vivo diastolic function characterization of the same physiologic process, their characterization of IVR in the pressure phase plane is strikingly different and no smooth and continuous transformation between them exists. To avoid the parametric discontinuity between {tau} and {tau}Land more fully characterize isovolumic relaxation in mechanistic terms, we modeled ventricular IVR kinematically employing a traditional, lumped relaxation (resistive) and a novel elastic parameter. The model predicts IVR pressure as a function of time as solution of d2P/dt2+1/µdP/dt+EkP=0, where µ [ms] is a relaxation rate (resistance) similar to {tau} or {tau}L, and Ek [1/s2] is an elastic (stiffness) parameter (per unit mass). Validation involved analysis of 310 beats (10 consecutive beats for 31 subjects). This model fit the IVR data as well or better than τ and τLin all cases (mean RMSE dP/dt vs. t 29 mmHg/s for model; and 35 mmHg/s or 65 mmHg/s for {tau} and {tau}L respectively). The solution naturally encompasses {tau} and {tau}L as parametric limits and good correlation between {tau} and 1/µEk ({tau}=1.15/µEk-11.85 r2=0.96) indicates that isovolumic pressure decline is determined jointly by elastic (Ek) and resistive (1/µ) parameters. We conclude that pressure decline during IVR is incompletely characterized by resistance (i.e. {tau} and {tau}L) alone, but is determined jointly by elastic (Ek) and resistive (1/µ) mechanisms.




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Am. J. Physiol. Heart Circ. Physiol.Home page
L. Shmuylovich and S. J. Kovacs
Stiffness and relaxation components of the exponential and logistic time constants may be used to derive a load-independent index of isovolumic pressure decay
Am J Physiol Heart Circ Physiol, December 1, 2008; 295(6): H2551 - H2559.
[Abstract] [Full Text] [PDF]




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