Heart failure in pressure overload hypertrophy - The relative roles of ventricular remodeling and myocardial dysfunction
Heart failure in pressure overload hypertrophy - The relative roles of ventricular remodeling and myocardial dysfunction
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DOI：
10.1016/s0735-1097(01)01792-2
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发表时间：
2002-02-20
影响因子：
24
通讯作者：
Meyer, TE
中科院分区：
文献类型：
--
作者：
Norton, GR;Woodiwiss, AJ;Meyer, TE
我们试图探索心室重构和心肌功能障碍对压力超负荷肥大（POH）心力衰竭的相对贡献。背景POH心力衰竭的机制是不利的左心室（LV）腔室重构或心肌功能下降，或这些的组合。患有POH的动物被分类为患有心力衰竭的动物（POH-HF）或没有心力衰竭的动物（POH-NHF）。在体和离体实验中测定左室容积和心肌收缩、舒张功能。POH-HF组的心室重构的特征是左心室明显增大，相对壁厚正常（偏心重构），而POH-NHF组的重构特征是心室大小正常，相对壁厚增加（同心重构）。根据收缩末期压力-直径关系在体内和根据压力-容积关系在体外测定的LV收缩功能，POH-HF组低于POH-NHF组和假手术对照组。相比之下，两个PCH组的心肌功能是相似的，从应力-壁中缩短分数关系和心肌收缩刚度体内测定，并从LV收缩应力-应变关系的斜率离体。POH-HF组的舒张室刚度常数低于POH-NHF组，但心肌刚度常数在两个POH groups.CONCLUSIONS两个POH组不同主要是在他们的重塑过程中，这导致了一组慢性代偿状态和心力衰竭的其他。因此，POH患者的心力衰竭与有害的LV重构的关系比与心肌功能低下的关系更密切。(C)2002年，美国心脏病学会。
OBJECTIVES We sought to explore the relative contributions of ventricular remodeling and myocardial dysfunction to heart failure in pressure overload hypertrophy (POH).BACKGROUND The mechanism that underlies heart failure in POH is adverse left ventricular (LV) chamber remodeling or decreased myocardial function, or a combination of these.METHODS Twenty weeks after suprarenal aortic banding in rats, animals with POH were classified as those with heart failure (POH-HF) or those with no heart failure (POH-NHF). The LV chamber and myocardial systolic and diastolic functions were determined from in vivo and ex vivo experiments.RESULTS The LV mass was similar in both POH groups. Chamber remodeling in the POH-HF group was characterized by marked LV enlargement with a normal relative wall thickness (eccentric remodeling), whereas remodeling in the POH-NHF group was characterized by a normal chamber size and increased relative wall thickness (concentric remodeling). The LV systolic function, as determined in vivo from the end-systolic pressure-diameter relationship and ex vivo from the pressure-volume relationship, was lower in the POH-HF group than in the POH-NHF and sham-operated control groups. In contrast, myocardial function was similar in both PCH groups, as determined in vivo from the stress-midwall fractional shortening relationship and myocardial systolic stiffness, and ex vivo from the slope of the LV systolic stress-strain relationship. The diastolic chamber stiffness constant was lower in the POH-HF group than in the POH-NHF group, but the myocardial stiffness constant was similar in the two POH groups.CONCLUSIONS The two POH groups differed primarily in their remodeling process, which led to a chronically compensated state in one group and to heart failure in the other. Hence, heart failure in POH is more closely related to deleterious LV remodeling than to depressed myocardial function. (C) 2002 by the American College of Cardiology.