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Low coronary driving pressure is associated with subendocardial remodelling and left ventricular dysfunction in

Maria C Guido1, Clovis de Carvalho Frimm, Márcia K Koike

  • 1Laboratory of Medical Investigation, LIM-51, Department of Emergency Medicine, University of São Paulo Medical School, São Paulo, Brazil.

Clinical and Experimental Pharmacology & Physiology
|September 21, 2007
PubMed

Insights

Low coronary driving pressure in volume overload hypertrophy damages the heart's subendocardium. This early damage negatively impacts overall left ventricular function, highlighting a critical factor in cardiac remodeling.

Area of Science:

  • Cardiovascular Physiology
  • Cardiac Remodeling
  • Hemodynamics

Background:

  • Left ventricular remodeling in volume overload hypertrophy is not well understood.
  • Low diastolic blood pressure and high filling pressures may impair subendocardial perfusion.
  • The impact on global left ventricular remodeling remains unclear.

Purpose of the Study:

  • To investigate the role of coronary driving pressure in subendocardial remodeling.
  • To assess the effects of coronary driving pressure on cardiac function.
  • Utilized a rat model of aortocaval fistula (ACF).

Main Methods:

  • Wistar rats underwent ACF or sham operations.
  • Hemodynamic measurements (coronary driving pressure, dP/dt) were taken at 1 and 8 weeks.
  • Assessed cytokine expression, myeloperoxidase activity, metalloproteinase activity, and fibrosis in subendocardial and non-subendocardial layers.

Main Results:

  • ACF group had lower coronary driving pressure and cardiac function (+dP/dt, -dP/dt).
  • Initial coronary driving pressure independently predicted subendocardial fibrosis and cardiac function.
  • Matrix metalloproteinase-2 and inflammatory cytokines (IL-6, IL-1beta) were elevated in the subendocardium of ACF rats, correlating with low coronary driving pressure.

Conclusions:

  • Low coronary driving pressure early in ACF is a key determinant of subendocardial damage.
  • This subendocardial damage negatively influences left ventricular function.
  • Coronary driving pressure is a critical factor in the pathophysiology of volume overload-induced cardiac remodeling.

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