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Load-sensitive measures may overestimate global systolic function in the presence of left ventricular hypertrophy: a comparison with load-insensitive measures.
Connelly, K A; Prior, D L; Kelly, D J; Feneley, M P; Krum, H; Gilbert, R E.
Afiliación
  • Connelly KA; Dept. of Medicine, University of Melbourne, St. Vincent's Hospital, Victoria, Australia. connelly@medstv.unimelb.edu.au
Am J Physiol Heart Circ Physiol ; 290(4): H1699-705, 2006 Apr.
Article en En | MEDLINE | ID: mdl-16272203
Transgenic animal models have provided a vital insight into the pathogenesis of cardiovascular disease, but functional cardiac assessment is often limited by high heart rates and small heart size. We hypothesized that in the presence of concentric left ventricular (LV) hypertrophy (LVH), load-sensitive measures of contractility may be misinterpreted as overestimating global cardiac function, because the normal function of excess sarcomeres may displace a greater volume of blood during contraction. Conductance catheter technology was used to evaluate pressure-volume (P-V) relationships as a load-insensitive method of assessing cardiac function in vivo in 18-wk-old heterozygous (mRen-2)27 transgenic rats (a model of LVH), compared with age-matched Sprague-Dawley (SD) controls. Anesthetized animals underwent echocardiography followed by P-V loop analysis. Blood pressure, body weight, and heart rate were higher in the Ren-2 rats (P < 0.05). Load-sensitive measures of systolic function, including fractional area change, fractional shortening, ejection fraction, and positive peak rate of LV pressure development, were greater in the Ren-2 than control animals (P < 0.05). Load-insensitive measures of systolic function, including the preload recruitable stroke work relationship and the end-systolic P-V relationship, were not different between Ren-2 and SD rats. Regional wall motion assessed by circumferential shortening velocity suggested enhanced circumferential fiber contractility in the Ren-2 rats (P = 0.02), but tissue Doppler imaging, used to assess longitudinal function, was not different between groups. Although conventional measures suggested enhanced systolic function in the Ren-2 rat, load-insensitive measures of contractility were not different between Ren-2 and SD animals. These findings suggest that the normal range of values for load-sensitive indexes of contractility needs to be altered according to the degree of LVH. To accurately identify changes in systolic function, we suggest that a combination of echocardiography with assessment of load-insensitive measures be used routinely.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Hipertrofia Ventricular Izquierda / Disfunción Ventricular Izquierda / Pruebas de Función Cardíaca Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies Límite: Animals Idioma: En Revista: Am J Physiol Heart Circ Physiol Asunto de la revista: CARDIOLOGIA / FISIOLOGIA Año: 2006 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Buscar en Google
Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Hipertrofia Ventricular Izquierda / Disfunción Ventricular Izquierda / Pruebas de Función Cardíaca Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies Límite: Animals Idioma: En Revista: Am J Physiol Heart Circ Physiol Asunto de la revista: CARDIOLOGIA / FISIOLOGIA Año: 2006 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos