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Left ventricular systolic wall stress as a primary determinant of myocardial oxygen consumption: Comparative studies in patients with normal left ventricular function, with pressure and volume overload and with coronary heart disease

  • B. E. Strauer
  • K. Beer
  • K. Heitlinger
  • B. Höfling
Conference paper

Summary

Left ventricular dynamics, coronary blood flow (Vcor), and myocardial oxygen consumption (MVO2) were determined in normal patients (N), in chronic pressure overload (aortic stenosis, AS), in chronic volume overload (aortic incompetence, AI), and in coronary heart disease (CHD). Peak systolic and enddiastolic wall stress were increased in AS and AI by 26–52 per cent, the systolic stress being preferably increased in AS, whereas enddiastolic stress was markedly greater in AI. Vcor and MVO2 were elevated in both groups by 45–55 per cent (p < 0.001). Sufficient correlation was present between peak systolic wall stress and the MVO2 (r = 0.82). Since at a given wall stress the MVO2 was somewhat increased in AI and AS when compared with N and CHD, the considerable enhancement of the rate of pressure development (AS) as well as of the external cardiac work (AI) may contribute to the increase in overall oxygen consumption. It is concluded that systolic wall stress represents a primary determinant of MVO2 in pressure and volume overload and that the MVO2 increases in these diseases when hypertrophy becomes inappropriate with regard to the pressure and volume demands imposed to the left ventricle.

Vergleichende Untersuchungen über die Beziehungen zwischen der Ventrikelfunktion, Kontraktilität und maximalen systolischen Wandspannung sowie dem Sauerstoffverbrauch des linken Ventrikels bei Patientengruppen mit Normalfunktion, chronischer Druck-und Volumenbelastung und koronarer Herzkrankheit

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References

  1. 1.
    Braunwald, E.: Control of myocardial oxygen consumption. Physiological and clinical considerations. Amer. J. Cardiol. 27, 416 (1971).PubMedCrossRefGoogle Scholar
  2. 2.
    Bretschneider, H. J., L. Cott, G. Hilgert, R. Probst, G. Rau: Gaschromatische Trennung und Analyse von Argon als Basis einer neuen Fremdgasmethode zur Durchblutungsmessung von Organen. Verh. Dtsch. Ges. Kreislaufforschg. 32, 267 (1966).Google Scholar
  3. 3.
    Greene, D. G., R. Carlisle, C. Grant, I. Bunnell: Estimation of left ventricular volume by one-plane cineangiography. Circulation 35, 61 (1967).PubMedGoogle Scholar
  4. 4.
    Hood, W. P., Ch. E. Rackley, E. L. Rolett: Wall stress in the normal and hypertrophied human left ventricle. Amer. J. Cardiol. 22, 550 (1968).Google Scholar
  5. 5.
    Kochsiek, K., M. Tauchert, L. Cott, J. Neubaur: Die Coronarreserve bei Patienten mit Aortenvitien. Verh. Dtsch. Ges. inn. Med. 76, 214 (1970).Google Scholar
  6. 6.
    Sandler, H., H. T. Dodge: Left ventricular tension and stress in man. Circulat. Res. 13, 91 (1963).PubMedGoogle Scholar
  7. 7.
    Sandler, H., H. T. Dodge: The use of single plane angiocardiograms for the calculation of left ventricular volume in man. Amer. Heart J. 75, 325 (1968).PubMedCrossRefGoogle Scholar
  8. 8.
    Strauer, B. E., M. Tauchert, L. Cott, K. Kochsiek, H. J. Bretschneider: Simultane Bestimmung des Stauerstoffverbrauches und der Coronardurchblutung des linken Ventrikels bei Mitral-und Aortenklappenfehlern mit einem neuen hämodynamischen Parameter und der Argon-Fremdgasmethode. Verh. Dtsch. Ges. inn. Med. 76, 217 (1970).Google Scholar
  9. 9.
    Strauer, B. E., M. Tauchert, L. Cott, H. W. Heiss, K. Kochsiek, H. J. Bretschneider: ‘Ober den Einfluß verschiedener Größen der Herzmechanik auf den Sauerstoffverbrauch des suffizienten und insuffizienten linken Ventrikels bei Aortenvitien. Verh. Dtsch. Ges. inn. Med. 77, 876 (1971).Google Scholar
  10. 10.
    Strauer, B. E., M. Tauchert, H. W. Heiss, K. Kochsiek, H. J. Bretschneider: Relation between coronary blood flow, oxygen consumption and cardiac work in patients with and without angina pectoris. p. 465–475. In: “Myocardial blood flow in man”. Ed. A. Maseri (Torino 1972 ).Google Scholar
  11. 11.
    Strauer, B. E., M. Tauchert: Evidence for an inefficient energy utilization in cardiac hypertrophy. Studies on the isolated human ventricular myocardium. Klin. Wschr. 51, 322 (1973).PubMedCrossRefGoogle Scholar
  12. 12.
    Strauer, B. E., I. Brune, H. Schenk, D. Knoll, E. Perings: Lupus Cardiomyopathy. Cardiac mechanics, hemodynamics and coronary blood flow in uncomplicated systemic lupus erythematosus. Amer. Heart J. 92, 715 (1976).PubMedCrossRefGoogle Scholar
  13. 13.
    Strauer, B. E., H. Kramer, H. Avenhaus, H.-D. Bolte, B. Luderitz, J. Neubaur, G. Riecker: Hämodynamik, Volumina und Dehnbarkeit des linken Ventrikels bei 167 Patienten mit angeborenen und erworbenen Herzfehlern. Klin. Wschr. 53, 961 (1975).PubMedCrossRefGoogle Scholar
  14. 14.
    Tauchert, M., K. Kochsiek, H. W. Heiss, G. Rau, H. J. Bretschneider: Technik der Organdurchblutungsmessung mit der Argon-Methode. Z. Kreislaufforschg. 60, 871 (1971).Google Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag, Darmstadt 1977

Authors and Affiliations

  • B. E. Strauer
    • 1
  • K. Beer
    • 1
  • K. Heitlinger
    • 1
  • B. Höfling
    • 1
  1. 1.Medizinische Klinik IUniversität MünchenMünchen 70Deutschland

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