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Cardiac Oxygen Costs of Contractility (Emax) and Mechanical Energy (PVA): New Key Concepts in Cardiac Energetics

  • Chapter
Recent Progress in Failing Heart Syndrome

Summary

Experimental studies on cardiac mechanoenergetics performed over the last decade in our laboratory are reviewed and the new concepts obtained from them are summarized. We have proposed that the contractile state of the ventricle can be quantified by the end-systolic ventricular maximum volume elastance (Emax) and that the total mechanical energy of ventricular contraction can be quantified by the systolic pressure-volume area (PVA). Emax is the slope of a linearized end-systolic pressure-volume relation and PVA is the area circumscribed by the end-systolic and end-disatolic pressure-volume relation curves and the systolic pressure-volume trajectory in the ventricular pressure-volume diagram.

We have shown that PVA correlates linearly with ventricular oxygen consumption (Vo2) regardless of ventricular loading conditions at a stable Emax and that the load-independent Vo2-PVA relation is shifted up or down in a parallel manner with enhancement or depression of Emax by various inotropic interventions. These experimental findings can be described by the empirical equations Vo2 = aPVA + b, and b = cEmax + d. Coefficient a is the oxygen cost of PVA or mechanical energy, aPVA is the PVA-dependent Vo2, constant b is the PVA-independent Vo2, c is the oxygen cost of Emax or contractility, and constant d means the PVA-independent Vo2 at zero Emax. The reciprocal of a refers to the efficiency of PVA generation from the PVA-dependent Vo2, and is called the contractile efficiency. The value for a has been found to be about 1.8 x 10−5ml O2/(mmHg ml) or 2.5 (dimensionless) after the units of both Vo2 and PVA are changed to a common unit of energy (1ml O2 = 20 J, 1mmHg ml = 1.33 x 10−4J). Therefore, 1/a is 0.4 (dimensionless) or 40% on average. We have found that a and c are independent of inotropic interventions although b changes. However, myocardial stunning slightly decreased a and d and doubled c, and myocardial cooling did not change a and c. We consider that the behaviors of a, b, c and d can characterize the mechanoenergetic changes of hearts under various pathophysiological conditions.

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Authors and Affiliations

  1. The Second Department of Physiology, Okayama University Medical School, Okayama, 700, Japan

    Hiroyuki Suga

  2. Department of Cardiovascular Dynamics, National Cardiovascular Center Research Institute, Suita, Osaka, 565, Japan

    Yoichi Goto

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  1. Hiroyuki Suga
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  2. Yoichi Goto
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Editors and Affiliations

  1. The Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, 930-01, Toyama, Japan

    Shigetake Sasayama M.D. (Professor of Medicine) (Professor of Medicine)

  2. Okayama University Medical School, 2-5-1, Shikata-cho, 700, Okayama, Japan

    Hiroyuki Suga M.D., D.M. SC. (Professor of Physiology) (Professor of Physiology)

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© 1991 Springer-Verlag Tokyo

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Suga, H., Goto, Y. (1991). Cardiac Oxygen Costs of Contractility (Emax) and Mechanical Energy (PVA): New Key Concepts in Cardiac Energetics. In: Sasayama, S., Suga, H. (eds) Recent Progress in Failing Heart Syndrome. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67955-4_4

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  • DOI: https://doi.org/10.1007/978-4-431-67955-4_4

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68019-2

  • Online ISBN: 978-4-431-67955-4

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