Ventricular-arterial uncoupling in heart failure with preserved ejection fraction after myocardial infarction in dogs - invasive versus echocardiographic evaluation

BMC Cardiovascular Disorders

Research Article

Guy R Heyndrickx¹  Jozef Bartunek²  Maryam Mahmoudabady³  Serge Brimioulle³  Robert Naeije³  Karim Touihri³  Myrielle Mathieu³  Ielham Hadad³  Kathleen Mc Entee³  Bachar El Oumeiri⁴  Philippe Thoma⁵  Thierry Metens⁵ 

[1] Cardiovascular Center, OLV Hospital, Aalst, Belgium;Cardiovascular Center, OLV Hospital, Aalst, Belgium;Faculty of Biomedical engineering, TU Eindhoven, The Netherlands;Department of Physiology and Pathophysiology, Faculty of Medicine, ULB, Brussels, Belgium;Department of Physiology and Pathophysiology, Faculty of Medicine, ULB, Brussels, Belgium;Cardio-Thoracic Surgery Department, Mont Godinne Hospital, UCL, Yvoir, Belgium;Department of Radiology and Medical Imaging, ULB, Brussels, Belgium;

关键词: Diastolic Function;    Fractional Shorten;    Preserve Ejection Fraction;    Active Relaxation;    Wall Motion Score Index;   

DOI  :  10.1186/1471-2261-10-32

 received in 2010-03-03, accepted in 2010-06-29,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundHeart failure with preserved left ventricular ejection fraction and abnormal diastolic function is commonly observed after recovery from an acute myocardial infarction. The aim of this study was to investigate the physiopathology of heart failure with preserved ejection fraction in a model of healed myocardial infarction in dogs.MethodsEchocardiography, levels of neurohormones and conductance catheter measurements of left ventricular pressure-volume relationships were obtained in 17 beagle dogs 2 months after a coronary artery ligation, and in 6 controls.ResultsHealed myocardial infarction was associated with preserved echocardiographic left ventricular ejection fraction (0.57 ± 0.01, mean ± SEM) and altered Doppler mitral indices of diastolic function. NT-proBNP was increased, aldosterone was decreased, and norepinephrine was unchanged. Invasive measurements showed a markedly decreased end-systolic elastance (2.1 ± 0.2 vs 6.1 ± 0.8, mmHg/ml, p < 0.001) and end-systolic elastance to effective arterial elastance ratio (0.6 ± 0.1 vs 1.4 ± 0.2, p < 0.001), with altered active relaxation (dP/dtmin -1992 ± 71 vs -2821 ± 305, mmHg/s, p < 0.01) but preserved left ventricular capacitance (70 ± 6 vs 61 ± 3, ml at 20 mmHg, p = NS) and stiffness constant. Among echocardiographic variables, the wall motion score index was the most reliable indicator of cardiac contractility while E', E/A and E'/A' were correlated to dP/dtmin.ConclusionsIn the canine model of healed myocardial infarction induced by coronary ligation, heart failure is essentially characterized by an altered contractility with left ventricular-arterial uncoupling despite vascular compensation rather than by abnormal diastolic function

【 授权许可】

CC BY   
© Mathieu et al; licensee BioMed Central Ltd. 2010