Evaluation of left ventricular mechanical restitution in closed-chest dogs based on single-beat elastance.

Abstract

The mechanical restitution of the left ventricle of closed-chest dogs was modeled as a monoexponential relation, using peak single-beat elastance as a measure of contractile strength. Data were obtained from nine dogs chronically instrumented with three sets of piezoelectric diameter gauges to assess ventricular volume and high-fidelity manometers to measure pressure. Mechanical restitution curves were obtained during both atrial and ventricular pacing in six dogs. The time constant of mechanical restitution was 64.3 +/- 11.4 msec for atrial and 122.2 +/- 26.3 msec for ventricular paced runs (p less than 0.01). These values are smaller than those previously reported from isolated hearts or isolated muscle segments. Although the time of onset of mechanical restitution was longer for atrial than for ventricular runs (255.1 +/- 14.3 versus 225.1 +/- 9.6 msec, p less than 0.05), the plateau to which mechanical function rose was not different. During ventricular pacing, fusion beats were noted in four dogs. The magnitude of the mechanical contribution of these fusion beats fell to a nadir at approximately 250 msec, suggesting that intracellular calcium available for crossbridge interaction is dropping during this time. In three additional dogs, the time constant of postextrasystolic restitution was found to vary depending on the preceding extrasystolic interval. Thus, mechanical restitution of the ventricle is a dynamic process that can be assessed using an elastance-based approach in the in situ heart.