Abstract
The objective of this study was to define alterations in ventricular–arterial (V-A) coupling early in the development of tachycardia-induced heart failure (HF). Although HF is characterized by impaired V-A coupling, the temporal relationship of these derangements to overt left ventricular (LV) dysfunction is unknown. Six anesthetized dogs instrumented with LV manometers and piezoelectric crystals were studied before and after 24 h of rapid ventricular pacing (RVP). V-A coupling was indexed by the ratio between the end-systolic pressure–volume relation slope (endsystolic elastance, E ES) and effective arterial elastance (E A), and mechanical efficiency by the ratio of stroke work (SW) to pressure–volume area (PVA). After RVP, there was no significant depression of LV function, but E A and total peripheral resistance (R T) were increased (P < 0.05), indicating increased arterial load. After RVP, E ES/E A and SW/PVA were maintained during unstressed conditions, but upon changes in load induced by phenylephrine, E ES/E A declined more precipitously with equivalent increases in R T (slope E ES/E A–R T relation −16.7 ± 4.6 vs −5.8 ± 4.0 ml/mmHg·min, P < 0.025). Furthermore, after RVP there was significant (P < 0.05) blunting of dobutamine-induced augmentation of E ES, E ES/E A, and SW/PVA. Thus, after RVP there was a distinct loss of V-A coupling reserve during afterload and catecholamine stress. V-A coupling defects occur early in the development of tachycardia-induced HF prior to significant pump dysfunction, and are manifested primarily during hemodynamic and inotropic stress.
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References
K Sunagawa WL Maughan D Burkhoff K Sagawa (1983) ArticleTitleLeft ventricular interaction with arterial load studied in isolated canine ventricle Am J Physiol 245 H773–H780 Occurrence Handle6638199 Occurrence Handle1:STN:280:BiuD2cbnvVE%3D
K Sunagawa WL Maughan K Sagawa (1985) ArticleTitleOptimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle Circ Res 56 586–595 Occurrence Handle3978773 Occurrence Handle1:STN:280:BiqC2M3ktlY%3D
D Burkhoff K Sagawa (1986) ArticleTitleVentricular efficiency predicted by an analytical model Am J Physiol 250 R1021–R1027 Occurrence Handle3717375 Occurrence Handle1:STN:280:BimB3sbntVQ%3D
WC Little CP Cheng (1991) ArticleTitleLeft ventricular-arterial coupling in conscious dogs Am J Physiol 261 H70–H76 Occurrence Handle1858932 Occurrence Handle1:STN:280:By6A3MvnvF0%3D
WC Little CP Cheng (1993) ArticleTitleEffect of exercise on left ventricular-arterial coupling assessed in the pressure-volume plane Am J Physiol 264 H1629–H1633 Occurrence Handle8098914 Occurrence Handle1:STN:280:ByyB2s%2Fht1I%3D
N Ohte CP Cheng WC Little (2003) ArticleTitleTachycardia exacerbates abnormal left ventricular-arterial coupling in heart failure Heart Vessels 18 136–141 Occurrence Handle12955429 Occurrence Handle10.1007/s00380-003-0697-9
RP Kelly CT Ting TM Yang CP Liu WL Maughan MS Chang DA Kass (1992) ArticleTitleEffective arterial elastance as index of arterial vascular load in humans Circulation 86 513–521 Occurrence Handle1638719 Occurrence Handle1:STN:280:By2A2cnotlQ%3D
H Asanoi S Sasayama T Kameyama (1989) ArticleTitleVentriculoarterial coupling in normal and failing heart in humans Circ Res 65 483–493 Occurrence Handle2752553 Occurrence Handle1:STN:280:BiaA38vjt1Q%3D
R Zelis SF Flaim (1982) ArticleTitleAlterations in vasomotor tone in congestive heart failure Prog Cardiovasc Dis 24 437–459 Occurrence Handle6805039 Occurrence Handle10.1016/0033-0620(82)90012-3 Occurrence Handle1:STN:280:Bi2C1MfntFU%3D
R Hambrecht E Fiehn C Weigl S Gielen C Hamann R Kaiser J Yu V Adams J Niebauer G Schuler (1998) ArticleTitleRegular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure Circulation 98 2709–2715 Occurrence Handle9851957 Occurrence Handle1:CAS:528:DyaK1MXitFaqtw%3D%3D
B Hornig V Maier H Drexler (1996) ArticleTitlePhysical training improves endothelial function in patients with chronic heart failure Circulation 93 210–214 Occurrence Handle8548890 Occurrence Handle1:STN:280:BymC3svjvFE%3D
U Landmesser S Spiekemann S Dikalov H Tatga R Wilke C Kohler DG Harrison B Hornig H Drexler (2002) ArticleTitleVascular oxidative stress and endothelial dysfunction in patients with chronic heart failure: role of xanthine-oxidase and extracellular superoxide dismutase Circulation 106 3073–3078 Occurrence Handle12473554 Occurrence Handle10.1161/01.CIR.0000041431.57222.AF Occurrence Handle1:CAS:528:DC%2BD38XptFKgsLo%3D
GM Eaton RJ Cody PF Binkley (1993) ArticleTitleIncreased aortic impedance precedes peripheral vasoconstriction at the early stage of ventricular failure in the paced canine model Circulation 88 2714–2721 Occurrence Handle8252683 Occurrence Handle1:STN:280:ByuD2svgvVQ%3D
Z Khan RW Millard M Gabel RA Walsh BD Hoit (1999) ArticleTitleEffect of congestive heart failure on in vivo canine aortic elastic properties J Am Coll Cardiol 33 267–272 Occurrence Handle9935040 Occurrence Handle10.1016/S0735-1097(98)00530-0 Occurrence Handle1:STN:280:DyaK1M7jtFOguw%3D%3D
SD Prabhu (1999) ArticleTitleLoad sensitivity of left ventricular relaxation in normal and failing hearts: evidence of a biphasic response Cardiovasc Res 43 354–363 Occurrence Handle10536665 Occurrence Handle10.1016/S0008-6363(99)00102-9 Occurrence Handle1:CAS:528:DyaK1MXlsVKru7s%3D
SD Prabhu GL Freeman (1995) ArticleTitleEffect of tachycardia heart failure on the restitution of left ventricular function in closed-chest dogs Circulation 91 176–185 Occurrence Handle7805200 Occurrence Handle1:STN:280:ByqC3czntFY%3D
SD Prabhu GL Freeman (2000) ArticleTitleAltered LV inotropic reserve and mechanoenergetics early in the development of heart failure Am J Physiol Heart Circ Physiol 278 H698–H705 Occurrence Handle10710336 Occurrence Handle1:CAS:528:DC%2BD3cXhvFaqtLc%3D
H Suga (1990) ArticleTitleVentricular energetics Physiol Rev 70 247–277 Occurrence Handle2181496 Occurrence Handle1:STN:280:By%2BB3cjksl0%3D
SH Kubo TS Rector AJ Bank RE Williams SM Heifetz (1991) ArticleTitleEndothelium-dependent vasodilation is attenuated in patients with heart failure Circulation 84 1589–1596 Occurrence Handle1914099 Occurrence Handle1:STN:280:By2D3cngsFw%3D
B Hornig N Arakawa C Kohler H Drexler (1998) ArticleTitleVitamin C improves endothelial function of conduit arteries in patients with chronic heart failure Circulation 97 363–368 Occurrence Handle9468210 Occurrence Handle1:CAS:528:DyaK1cXhtVCqsL0%3D
TS Rector AJ Bank KA Mullen LK Tschumperlin R Sih K Pillai SH Kubo (1997) ArticleTitleRandomized, double-blind, placebo-controlled study of supplemental oral L-arginine in patients with heart failure Circulation 85 2135–2141
M Nakamura S Sugawara N Arakawa M Nagano T Shizuka Y Shimoda T Sakai K Hiramori (2004) ArticleTitleReduced vascular compliance is associated with impaired endothelium-dependent dilatation in the brachial artery of patients with congestive heart failure J Card Fail 10 IssueID1 36–42 Occurrence Handle14966773 Occurrence Handle10.1016/S1071-9164(03)00585-2 Occurrence Handle1:CAS:528:DC%2BD2cXht1Kit7s%3D
AJ Bank PC Lee SH Kubo (2000) ArticleTitleEndothelial dysfunction in patients with heart failure: relationship to disease severity J Card Fail 6 29–36 Occurrence Handle10746816 Occurrence Handle10.1016/S1071-9164(00)00009-9 Occurrence Handle1:STN:280:DC%2BD3c3gvVKjtw%3D%3D
S Srivastava B Chandrasekar A Bhatnagar SD Prabhu (2002) ArticleTitleLipid-peroxidation derived aldehydes and oxidative stress in the failing heart: role of aldose reductase Am J Physiol Heart Circ Physiol 283 H2612–H2619 Occurrence Handle12388223 Occurrence Handle1:CAS:528:DC%2BD38XpvVWisr4%3D
T Kubota J Alexander SuffixJr R Itaya K Todaka M Sugimachi K Sunagawa Y Nose A Takeshita (1992) ArticleTitleDynamic effects of carotid sinus baroreflex on ventriculoarterial coupling studied in anesthetized dogs Circ Res 70 1044–1053 Occurrence Handle1568296 Occurrence Handle1:STN:280:By2B3szlsFE%3D
GL Freeman (1990) ArticleTitleEffects of increased afterload on left ventricular function in closed-chest dogs Am J Physiol 259 H619–H625 Occurrence Handle2386232 Occurrence Handle1:STN:280:By%2BA2M%2FovVc%3D
GL Freeman JT Colston (1990) ArticleTitleRole of ventriculovascular coupling in cardiac response to increased contractility in closed-chest dogs J Clin Invest 86 1278–1284 Occurrence Handle2212012 Occurrence Handle1:STN:280:By6D3cbotlE%3D Occurrence Handle10.1172/JCI114835
K Kiuchi RP Shannon K Komamura DJ Cohen C Bianchi CJ Homcy SF Vatner DE Vatner (1993) ArticleTitleMyocardial β-adrenergic receptor function during the development of pacing-induced heart failure J Clin Invest 91 907–914 Occurrence Handle8383704 Occurrence Handle1:CAS:528:DyaK3sXitlWntLs%3D
SD Prabhu GL Freeman (1993) ArticleTitleLeft ventricular energetics in closed-chest dogs Am J Physiol 265 H1048–H1055 Occurrence Handle8238392 Occurrence Handle1:STN:280:ByuD2MnotFw%3D
WC Little CP Cheng T Peterson J Vinten-Johansen (1988) ArticleTitleResponse of the left ventricular end-systolic pressure-volume relation in conscious dogs to a wide range of contractile states Circulation 78 736–745 Occurrence Handle3409508 Occurrence Handle1:STN:280:BieA3M7ksFc%3D
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Prabhu, S. Altered left ventricular–arterial coupling precedes pump dysfunction in early heart failure. Heart Vessels 22, 170–177 (2007). https://doi.org/10.1007/s00380-006-0954-9
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DOI: https://doi.org/10.1007/s00380-006-0954-9