Systolic mechanical properties of the left ventricle. Effects of volume and contractile state.

Abstract

To characterize the mechanical properties of the contracting left ventricle, we studied the changes in left ventricular systolic pressure following step-like perturbations (+/- 3 ml) in ventricular volume, using an isovolumically beating, isolated canine heart preparation. Three mechanical properties (elasticity, resistance, and a deactivation effect) were identified. The elastic property differs from the traditional parallel and series elastic elements; it is a time-varying elasticity that includes active and passive effects of volume changes. Furthermore, it could not be represented by a simple time-varying elasticity, but required a second factor to express the dependence of end-systolic elasticity on the timing of the volume step. This effect was represented by a "volume influence factor," which may arise from length-dependent activation. The resistive property appeared to be related to force-velocity behavior of the myocardium. Each mechanical property reacted characteristically to steady state changes in ventricular filling volume or contractile state produced by dobutamine (2-13 micrograms/min). Our findings indicate that elasticity was the property most sensitive to changes in contractile state; these changes increased peak isovolumetric pressure 54% on average, and raised elastic stiffness 40% above control (which was 5.1 mm Hg/ml). Changes in ventricular filling volume only prolonged, but did not alter, the level of elastic stiffness attained at peak pressure. These results support the view that elasticity--or the end-systolic pressure-volume relationship--serves in a given heart to quantify contractility. The "volume influence factor" was not affected by either filling volume or contractile state. Resistance increased in direct proportion with ventricular pressure, but this linear relation was not altered greatly by changes in contractile state or in ventricular filling volume. At 100 mm Hg, ventricular resistance averaged 0.11 mm Hg/ml per sec. Finally, deactivation was greater the later in systole a volume step was imposed, and this pattern was independent of changes in ventricular filling volume and in contractile state.