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Dyssynchrony of segment shortening in the anterior wall of the feline left ventricle.
Authors:E Hexeberg  K Matre  S Birkeland  J Lekven
Institution:Department of Surgery, Haukeland Hospital, University of Bergen, Norway.
Abstract:Non-uniformity of regional contraction may be both spatial and temporal. This study was undertaken to deal with the temporal aspects of shortening and to quantify non-uniformity with regard to timing. Nine cats were anaesthetized and artificially ventilated. Two pairs of ultrasonic crystals were situated in the anterior midwall of the left ventricle to measure regional shortening. One pair, longitudinal segment, was oriented to align with midwall fibres. The other pair, transverse segment, was placed perpendicular to the first one. Registrations in control state, during caval occlusion, and during aortic constriction were carried out with and without isoprenaline infusion. Cyclic events were analysed in terms of phase angle, 0-2 pi representing one heart cycle. Transverse segments showed marked shift of duration of shortening, from 1.19 pi +/- 0.06 pi (mean +/- SEM) in the control state to 0.40 pi +/- 0.14 pi during caval occlusion with isoprenaline infusion. Duration of shortening of longitudinal segments showed less prominent shift with mean values between 1.38 pi and 1.11 pi. Regional uniformity of timing, expressed as synchronization index, varied markedly with interventions (P less than 0.0005). Dyssynchrony was most prominent during caval occlusion with mean values less than 0.6. A simple model of force generation for the two segments visualizes that segment shortening of the transverse segment is of shorter duration than the longitudinal segment and a common mechanism for temporal and spatial non-uniformity within a region could be elaborated. This study quantifies both the time course of shortening and temporal non-uniformity of two cross-oriented segments within the same myocardial region.
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