Journal of Applied Physiology Journal of Applied Physiology
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J Appl Physiol (December 7, 2006). doi:10.1152/japplphysiol.00976.2006
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Submitted on September 4, 2006
Accepted on December 4, 2006

The effect of a myocardial infarction on the normalized time-varying elastance curve

David Jegger1*, Ajit S Mallik2, Mohammed Nasratullah3, Xavier Jeanrenaud3, Rafaela da Silva2, Hendrik Tevaearai4, Ludwig K von Segesser5, and Nikos Stergiopulos1

1 Institute for Biomedical Engineering, EPFL, Lausanne, Switzerland
2 EPFL, Laboratory of Haemodynamics and Cardiovascular Technology, Lausanne, Switzerland
3 Department of Cardiology, CHUV, Lausanne, Switzerland
4 Department of Cardiovascular Surgery, Inselspital, Bern, Switzerland
5 Department of Cardiovascular Surgery, CHUV, Lausanne, Switzerland

* To whom correspondence should be addressed. E-mail: david.jegger{at}epfl.ch.

It has been suggested that the shape of the normalized time-varying elastance curve, En(tn), is conserved in different cardiac pathologies. We hypothesize, however, that the En(tn) differs quantitatively after myocardial infarction (MI). Sprague-Dawley rats (n=9) were anesthetized and the left anterior descending coronary artery was ligated to provoke the MI. A sham operated control group (CTRL) (n=10) was treated without the MI. Two months later, a conductance catheter was inserted into the left ventricle (LV). The LV pressure and volume were measured and the En(tn) derived. Slopes of En(tn) during the pre-ejection period ({alpha}PEP), ejection period ({alpha}EP) and their ratio ({beta}={alpha}EP/{alpha}PEP ) were calculated, together with the characteristic decay time during isovolumic relaxation ({tau}) and the normalized elastance at end diastole (Enmin). MI provoked significant LV chamber dilatation thus loss in cardiac output (-33%), ejection fraction (-40%) and stroke volume (-30%)(p<0.05). Also, it caused significant calcium increase (17 fold), fibrosis (2 fold) and LV hypertrophy. End-systolic elastance dropped from 0.66±0.31mmHg/µl (CTRL) to 0.34±0.11mmHg/µl (MI)(p<0.05). Normalized elastance was significantly reduced in the MI group during the pre-ejection, ejection and diastolic period (p<0.05). The slope of En(tn) during the {alpha}PEP, and {beta} were significantly altered after MI (p<0.05). Further, {tau} and end-diastolic Enmin were both significantly augmented in the MI group. We conclude that the En(tn) differs quantitatively, in all phases of the heart cycle, between normal and hearts post MI. This should be considered when utilizing the single-beat concept.




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