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Related Experiment Videos

Left ventricular shape changes during the course of evolving heart failure.

H N Sabbah1, T Kono, P D Stein

  • 1Henry Ford Heart and Vascular Institute, Division of Cardiovascular Medicine, Detroit, Michigan 48202.

The American Journal of Physiology
|July 1, 1992
PubMed
Summary

In chronic heart failure, changes in left ventricular (LV) shape occur before significant LV dysfunction and dilation develop. These LV shape abnormalities precede sympathetic nervous system activation.

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Area of Science:

  • Cardiology
  • Physiology
  • Biomedical Engineering

Background:

  • Chronic heart failure (CHF) is characterized by progressive left ventricular (LV) dysfunction and dilation.
  • The role of LV shape changes in the development and progression of CHF is not fully understood.
  • Sympathoadrenergic hyperactivity is a known complication of advanced heart failure.

Purpose of the Study:

  • To investigate the temporal relationship between left ventricular (LV) shape alterations and the onset of LV dysfunction, dilation, and sympathoadrenergic hyperactivity in a canine model of chronic heart failure.
  • To determine if changes in LV geometry precede or follow the development of cardiac dysfunction and neurohormonal activation.

Main Methods:

  • Chronic heart failure was induced in 10 dogs via sequential intracoronary microembolizations.

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  • Left ventricular (LV) shape was quantified using ventriculograms, measuring the ratio of major to minor axes at end-systole and end-diastole.
  • Measurements were taken at baseline and at 2, 8, and 16 weeks post-embolization.

    • Main Results:

    • A significant increase in LV sphericity was observed by 2 weeks, with minimal further changes up to 16 weeks.
    • Despite plateauing LV shape changes, LV ejection fraction progressively declined, and LV end-diastolic volume increased significantly between 2 and 16 weeks.
    • Plasma norepinephrine concentrations, indicative of sympathoadrenergic activity, also significantly increased over the 16-week period.

    Conclusions:

    • Left ventricular (LV) shape abnormalities, specifically increased sphericity, emerge early in the course of evolving chronic heart failure.
    • These geometric changes precede the development of profound LV dysfunction, dilation, and overt activation of the sympathetic nervous system.
    • LV shape quantification may serve as an early indicator of heart failure progression.