Relationship between total mechanical energy and oxygen consumption in the stunned myocardium

We studied the relationship between left ventricular oxygen consumption (LVVO2) and total ventricular mechanical energy production as determined by calculation of the systolic pressure-volume area (P-VA) before and after 25 minutes of warm ischemia in 7 sheep. We compared the relationship between LVVO2 and P-VA with the relationships between LVVO2 and stroke work and between LVVO2 and the systolic stress integral. Using the methods presented, P-VA can be measured in vivo (n = 123) in both preischemic and postischemic hearts. Ischemia increases the slopes of the relationship between LVVO2 and P-VA and between stroke work and the systolic stress integral, and reduces the oxygen utilization efficiency of stroke work to less than 2%. Coefficients of determination for the relationship between LVVO2 and P-VA are, in general, higher than those between LVVO2 and either stroke work or the systolic stress integral. We conclude that systolic P-VA can be measured in vivo using recently developed methods and that it is applicable to postischemic "stunned" hearts. Because P-VA and LVVO2 can be converted into identical energy units, calculation of P-VA permits calculation of myocardial oxygen utilization efficiency.