Hemodynamic characteristics of hypertrophic and congestive cardiomyopathies.
- 1 January 1981
- journal article
- research article
- Published by Japanese Circulation Society in Japanese Circulation Journal
- Vol. 45 (9) , 1014-1024
- https://doi.org/10.1253/jcj.45.1014
Abstract
To elucidate the hemodynamics and mechanical properties of the myocardium in hypertrophic (HCM) and congestive cardiomyopathies (CCM), preload (end-diastolic stress), afterload (mid-systolic stress), contractility (peak positive dp/dt [change in pressure over time], (dp/dt)/DP40, ejection fraction, relaxation (peak negative dp/dt, time constant T), compliance (elastic stiffness constant, end-diastolic elastic stiffness), and performance (left ventricular minute work, left ventricular minute work/muscle mass) were determined in 19 patients with HCM, 11 with CCM and 15 normal subjects. Preload was in the normal range in HCM even with elevated left ventricular end-diastolic pressure. In cases of CCM it was high only when congesive heart failure was present. Afterload was mildly elevated in CCM with heart failure, but only half the normal value in patients with HCM. The 3 indices of contractility were in the normal range in patients with HCM and markedly reduced in those with CCM. Relaxation abnormalities were demonstrated in both HCM and CCM. The elastic stiffness constant was high in HCM and normal in CCM. End-diastolic stiffness was normal in HCM and high in CCM with heart failure. Chamber stiffness is markedly elevated in HCM, and stiffness of unit muscle is elevated in CCM when heart failure appears. Although left ventricular minute work was normal in HCM, minute work of unit muscle (left ventricular minute work/muscle mass) was markedly reduced. The chief problem in CCM apparently is contractile failure and that elevation of preload and muscle stiffness is associated with congestive heart failure in this disease. Although the conventional indices of contractility are in the normal range in HCM, the contractility of unit muscle is reduced, and hypertrophy seems to be a compensatory mechanism when the relations between afterload and ejection fraction and between preload and performance are considered.This publication has 9 references indexed in Scilit:
- The use of biplane angiocardiography for the measurement of left ventricular volume in manPublished by Elsevier ,2004
- A clinical study of left ventricular relaxation.Circulation, 1980
- HISTOPATHOLOGY OF ENDOMYOCARDIAL BIOPSIES FROM PATIENTS WITH IDIOPATHIC CARDIOMYOPATHY; QUANTITATIVE EVALUATION BASED ON MULTIVARIATE STATISTICAL ANALYSISJapanese Circulation Journal, 1980
- Alterations in left ventricular relaxation and diastolic compliance in congestive cardiomyopathyCardiovascular Research, 1979
- Left ventricular relaxation and filling in hypertrophic cardiomyopathy. An echocardiographic study.Heart, 1978
- Factors which affect the diastolic pressure-volume curve.Circulation Research, 1978
- Hemodynamic determinants of the time-course of fall in canine left ventricular pressure.Journal of Clinical Investigation, 1976
- Diastolic Properties of the Left VentricleAnnals of Internal Medicine, 1976
- A Method for Determining Left Ventricular Mass in ManCirculation, 1964