Abstract
The effects of myocardial contraction on the coronary flow are studied by means of an integrated structural model of left ventricular (LV) mechanics, coronary flow, and fluid and mass transport. This model relates global LV performance, and in particular coronary flow dynamics, to myocardial composition and structure and contractile sarcomere activity. Extravascular pressure is identified with hydrostatic tissue pressure,i. e., intramyocardial pressure (IMP), and is determined by the dynamics of myocardial contraction and fluid transport. Consistent with available experimental data, changes in myocardial function and contractile state are simulated by changing the sarcomere contractile properties or changing the LV loading conditions. The model's predictions are successfully compared with a wide range of experimental studies; all but one were performed at a constant coronary perfusion pressure and maximal vasodilation. The results indicate a domiant effect of the myocardial contractile state on coronary flow and a dissocation between coronary compression and LV cavity pressure (LVP) when the pressure is controlled by load changes. However, when active sarcomere contraction is regionally impaired by lidocaine, LVP plays an important role in the coronary flow characteristics. The model adequately predicts observations on the effect of cardiac contraction on systolic and diastolic coronary flows, as well as the role of LVP at different loading and contractile conditions. The analysis supports the hypothesis that coronary compression, as mediated through IMP, is independent of LV loading conditions and depends on myocardial contractility and coronary perfusion pressure.
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Abel, F. L., R. R. Zhao, and R. F. Bond. Contribution of extravascular compression to reduction of maximal coronary blood flow.Am. J. Physiol. 262:H68-H77, 1992.
Arts, T., and R. S. Reneman. Interaction between intramyocardial pressure (IMP) and myocardial circulation.J. Biomech. Eng. 107:51–56, 1985.
Beyar, R., and S. Sideman. A computer study of the left ventricular performance based on fiber structure, sarcomere dynamics and transmural electrical propagation velocity.Circ. Res. 55:358–375, 1984.
Beyar, R., and S. Sideman. Time-dependent coronary blood flow distribution in the left ventricular wall.Am. J. Physiol. 252:H417-H433, 1987.
Beyar, R., R. Caminker, D. Manor, and S. Sideman. Coronary flow patterns in normal and ischemic hearts: Transmyocardial and artery to vein distribution.Ann. Biomed. Eng. 21:435–458, 1993.
Beyar, R., R. Ben-Ari, C. A. Gibbons-Kroeker, J. V. Tyberg, and S. Sideman. The effect of interconnecting collagen fibers on LV function and intramyocardial compression.Cardiovasc. Res. 27(12):2254–2263, 1993.
Braunwald, E., E. H. Sonnenblick, and J. R. Ross. Mechanisms of cardiac contraction and relaxation. In: Heart Disease. A Textbook of Cardiovascular Medicine, edited by E. Braunwald. Philadelphia: W. B. Saunders Co., 1988, pp. 383–425.
Bruinsma, P., T. Arts, J. Dankelman, and J. A. E. Spaan. Model of the coronary circulation based on pressure dependence of coronary resistance and compliance.Basic Res. Card. 83:510–524, 1988.
Chadwick, R. S., A. Tedgui, J. B. Michel, J. Ohayon, and B. I. Levy. Phasic regional myocardial inflow and outflow: Comparison of theory and experiments.Am. J. Physiol. 258:H1687-H1698, 1990.
Doucette, J. W., M. Goto, A. E. Flynn, R. E. Austin, Jr., W. Husseini, and J. I. E. Hoffman. Effects of cardiac contraction and cavity pressure on myocardial blood flow.Am. J. Physiol. 265:H1342-H1352, 1993.
Downey, J. M., and E. S. Kirk. Inhibition of coronary blood flow by a vascular waterfall mechanism.Circ. Res. 36:753–760, 1975.
Guccione, J. M., A. D. McCulloch, and L. K. Waldman. Pissive material properties of intact ventricular myocardium determined from a cylindrical model.J. Biomech. Eng. 113: 42–55, 1991.
Hoffman, J. I. E., and J. A. E. Spaan. Pressure-flow relations in coronary circulation.Physiol. Rev. 70:331–390, 1990.
Holenstein, R., and R. M. Nerem. Parametric analysis of flow in the intramyocardial circulation.Ann. Biomed. Eng. 18:347–365, 1990.
Katz, S. A., and E. O. Feigl. Systole has little effect on diastolic coronary artery blood flow.Circ. Res. 62:443–451, 1988.
Kedem, O., and A. Katchalsky. Thermodynamic analysis of the permeability of biological membranes to nonelectrolytes.Biochim. Biophys. Acta 27:229–246, 1958.
Kouwenhoven, E., I. Vergroesen, Y. Han, and J. A. E. Spaan. Retrograde coronary flow is limited by time varying elastance.Am. J. Physiol. 263:H484-H490, 1992.
Krams, R., P. Sipkema, and N. Westerhof. Varying elastance concept may explain coronary systolic flow impediment.Am. J. Physiol. 257:H1471-H1479, 1989a.
Krams, R., P. Sipkema, J. Zegers, and N. Westerhof. Contractility is the main determinant of coronary systolic flow impediment.Am. J. Physiol. 257:H1936-H1944, 1989b.
Krams, R., P. Sipkema, and N. Westerhof. Coronary oscillatory flow amplitude is more affected by perfusion pressure than ventricular pressure.Am. J. Physiol. 258:H1889-H1898 1990.
Kresh, J. Y., M. Fox, S. K. Brockman, and A. Noordergraaf. Model-based analysis of transmural vessel impedance and myocardial circulation dynamics.Am. J. Physiol. 258:H262-H276, 1990.
Laine, G. A., and H. J. Granger. Microvascular, interstitial and lymphatic interactions in normal heart.Am. J. Physiol. 249:H834-H842, 1985.
Livingston, J. Z., J. R. Resar, and F. C. P. Yin. Effect of tetanic myocardial contraction on coronary pressure-flow relationships.Am. J. Physiol. 265:H1215-H1226, 1993.
Manor, D., R. Beyar, and S. Sideman. Pressure-flow characteristics of the coronary collaterals: A model study.Am. J. Physiol. 266:H310-H318, 1994.
Mulligan, L. J., D. Escobedo, and G. L. Freeman. Mechanical determinants of coronary blood flow during dynamic alterations in myocardial contractility.Am. J. Physiol. 265:H1112-H1118 1993.
Ohayon, J., and R. S. Chadwick. Effects of collagen microstructure on the mechanics of the left ventricle.Biophys. J. 54:1077–1088, 1988.
Olsson, R. A., R. Bunger, and J. A. E. Spaan. Coronary circulation. In: The Heart and Cardiovascular System (second edition) edited by H. A. Fozzard, E. Haber, R. B. Jennings, A. M. Katz, and H. E. Morgan. New York: Raven Press, Ltd., 1992, pp. 1393–1425.
Pinto, J. G., A constitutive description of contracting papillary muscle and its implications to the dynamics of the intact heart.J. Biomech. Eng. 109:181–190, 1987.
Pollack, G. H., and J. W. Krueger. Myocardial sarcomere mechanics: Some parallels with skeletal muscle. In: Cardiovascular System Dynanics, edited by Y. Baan, A. Noordegraaf, and J. Raines, Cambridge, MA: MIT Press, 1978, pp. 3–10.
Sagawa, K., H. Suga, A. A. Shoukas and K. M. Bakalar. End-systolic pressure/volume ratio: A new index of ventricular contractility.Am. J. Cardiol. 40:748–753, 1977.
Spaan, J. A. E. Coronary Blood Flow: Mechanics, Distribution and Control. Dordrecht: Kluwer Academic Publishers, 1992, pp. 131–188.
Spaan, J. A. E., N. P. W. Breuls, and J. D. Laird. Diastolic-systolic coronary flow differences are caused by intramyocardial pump action in the anesthetized dog.Circ. Res. 49:584–593, 1981.
Streeter, D. D., H. M. Spotnitz, D. P. Patel, J. Ross, and E. H. Sonnenblick. Fiber orientation in the canine left ventricle during diastole and systole.Circ. Res. 24:339–347. 1969.
Zinemanas, D., R. Beyar, and S. Sideman. Intramyocardial fluid transport effects on coronary flow and LV mechanics. In: Interactive Phenomena in the Cardiac System, edited by S. Sideman and R. Beyar. New York: Plenum Publishing Corp., 1993, pp. 219–231.
Zinemanas, D., R. Beyar, and S. Sideman. Relating mechanics, blood flow and mass transport in the cardiac muscle.Int. J. Heat Mass Transfer 37(1):191–205, 1994.
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Zinemanas, D., Beyar, R. & Sideman, S. Effects of myocardial contraction on coronary blood flow: An integrated model. Ann Biomed Eng 22, 638–652 (1994). https://doi.org/10.1007/BF02368289
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DOI: https://doi.org/10.1007/BF02368289