Predictive changes in ventricular interdependence |
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Authors: | Dr William P Santamore Martin Constantinescu Thomas Shaffer |
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Institution: | (1) Section of Cardiology Bowman Gray School of Medicine, Wake Forest University, 300 South Hawthorne Road, 27103 Winston-Salem, North Carolina;(2) Department of Physiology, Temple University, Philadelphia, Pennsylvania |
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Abstract: | Based on the balance of forces across the interventricular septum, we developed a theoretical analysis to explain how one
ventricle can directly influence the filling characteristics of the other ventricle. The analysis indicated that the pressure
and volume transfer were related to the relative compliances of the interventricular septum and ventricular free walls. The
present study examined whether the theoretical analysis could be used to predict changes in ventricular interdependence caused
by altering regional compliance. To examine this hypothesis, hearts were removed from 18 dogs and placed in cool cardioplegic
solution. Balloons were inserted into each ventricle, and the left and right pressure (δP1, δPr) and volume (δV1, δVr) changes caused by changing the pressure and volume of the other ventricle were recorded. After the initial measurements,
acute changes in left ventricular free wall compliance (n=6), septal compliance (n=6), and right ventricular free wall compliance
(n=6) were induced by glutaraldehyde injections. As predicted by the theoretical analysis, decreasing left ventricular free
wall compliance increased δP1/δPr, δP1/δVr, δPr/δV1, and δVr/δV1 significantly (P<0.05) by 89±15, 155±33, 282±65, and 112±22% (mean±SEM), respectively. Decreasing septal compliance decreases
δP1/δPr, δV1/δPr, δV1/δVr, δPr/δP1, and δVr/δV1 significantly (P<0.05) by 48±7, 71±10, 69±14, 48±7, 62±8, and 57±13%, respectively. Decreasing right ventricular free wall
compliance increased δP1/δVr, δV1/δVr, δPr/δP1, and δPr/δV1 significantly (P<0.05) by 97±25, 79±20, 57±18, and 59±23%, respectively. Furthermore, these alterations in ventricular coupling
were predictable: The actual and predicted percentage changes in the transfer functions were in close agreement. The results
of these studies show predictable alterations in the mechanical coupling between the ventricles following changes in right
ventricular septal, and left ventricular free wall compliances. |
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Keywords: | Ventricular interdependence Right ventricle Left ventricle Interventricular septum Hemodynamics Theoretical modeling |
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