Depressed mechanoenergetics and compensatory responses in idiopathic dilated cardiomyopathy

Hitoshi Ishihara, Mitsuhiro Yokota, Ryozo Kato, Hirofumi Kanda, Sahoko Ichihara, Takahiro Fujimura, Yasushi Takeichi, Ryoji Ishiki, Masafumi Inagaki, Hideo Izawa, Takeshi Machii, Mitsunori Iwase, Toshikazu Sobue

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Abstract

The aim of this study was to clarify that the depressed mechanoenergetics in patients with idiopathic dilated cardiomyopathy (DCM) resulted from compensation for the decreased contractility. The study population consisted of eight control subjects, with normal left ventricular size and ejection fraction and 31 patients with DCM. Left ventricular end-systolic elastance (Ees), effective arterial elastance (Ea), external work (EW), and the pressure-volume area (PVA) were measured, using a dual-field volume conductance catheter equipped with a micromanometer-tipped catheter. Ea/Ees was evaluated as ventriculoarterial coupling. Normal hearts worked at almost optimal condition (defined as Ea/Ees = 1/4 ), while ventriculoarterial coupling was far from the optimum (Ea > Ees) in patients with DCM. Ees in patients with DCM was less than that in control subjects; however, Ea was similar in the two groups. The mismatch of Ea/Ees observed in DCM leads to depressed mechanoenergetics as a result of the compensatory response to maintain adequate blood pressure. Volume enlargement plays an important role in maintaining adequate blood pressure and cardiac output in the course of chronic deterioration of contractility.

Original languageEnglish
Pages (from-to)93-96
Number of pages4
JournalHeart and Vessels
Volume12
Issue numberSUPPL. 12
Publication statusPublished - 01-12-1997
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Ishihara, H., Yokota, M., Kato, R., Kanda, H., Ichihara, S., Fujimura, T., Takeichi, Y., Ishiki, R., Inagaki, M., Izawa, H., Machii, T., Iwase, M., & Sobue, T. (1997). Depressed mechanoenergetics and compensatory responses in idiopathic dilated cardiomyopathy. Heart and Vessels, 12(SUPPL. 12), 93-96.