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Stroke volume-to-wall stress ratio as a load-adjusted and stiffness-adjusted indicator of ventricular systolic

Elie R Chemaly1, Antoine H Chaanine, Susumu Sakata

  • 1Cardiovascular Research Center, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|August 28, 2012
PubMed

Insights

The stroke volume-to-wall stress ratio offers a more accurate measure of systolic function, adjusting for both load and stiffness in pressure and volume overload hypertrophy models.

Area of Science:

  • Cardiology
  • Physiology
  • Biomedical Engineering

Background:

  • Load-adjusted measures of left ventricle (LV) systolic performance are limited by dependence on LV stiffness and afterload.
  • No stiffness-adjusted and afterload-adjusted indicator has been tested in pressure overload hypertrophy (POH) and volume overload hypertrophy (VOH) models.
  • Existing indicators show limitations in accurately reflecting systolic function under altered loading conditions.

Purpose of the Study:

  • To evaluate the stroke volume-to-wall stress ratio as a novel, load-adjusted, and stiffness-adjusted indicator of systolic function.
  • To compare the efficacy of this ratio against traditional indicators in rat models of POH and VOH.
  • To determine if wall stress accurately reflects changes in loading, chamber stiffness, and afterload.

Main Methods:

  • Utilized rat models of pressure overload hypertrophy (ascending aortic banding) and volume overload hypertrophy (aorto-cava shunt).
  • Performed echocardiography and pressure-volume analysis at baseline and during dobutamine challenge.
  • Assessed LV systolic performance, end-systolic elastance (Ees), passive stiffness, and arterial elastance (Ea).

Main Results:

  • The stroke volume-to-wall stress ratio was normal in compensated POH, markedly decreased in POH with heart failure, and normal in VOH.
  • Traditional indicators showed variability and limitations, with some remaining elevated in POH with failure and reduced in VOH despite preserved contractile reserve.
  • Calculated residual Ees was not reduced in POH with heart failure but was reduced in VOH, correlating positively with dobutamine dose.

Conclusions:

  • The stroke volume-to-wall stress ratio serves as a superior load-adjusted and stiffness-adjusted indicator of systolic function compared to traditional measures.
  • This ratio accurately reflects changes in loading conditions and chamber stiffness in both POH and VOH.
  • Findings support the clinical utility of the stroke volume-to-wall stress ratio for assessing LV systolic performance across different overload states.

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