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Aortic Reservoir Function has a Strong Impact on the Cardiac Blood Supply-Workload Balance in Children
Tomoaki Murakami1, Atsuhito Takeda2
1Department of Cardiology, Chiba Children's Hospital, 579-1 Heta-cho, Midori-ku, Chiba, 266-0007, Japan. murat@seagreen.ocn.ne.jp.
Insights
Aortic reservoir function, measured by percent diastolic runoff, is lower in children than adults. This function significantly impacts the heart
Area of Science:
- Cardiovascular Physiology
- Pediatric Cardiology
Background:
- The aorta stores systolic ejection blood, releasing it during diastole to maintain organ perfusion.
- The heart's blood supply-workload balance is crucial, particularly in pediatric populations where it may be suboptimal.
- Aortic reservoir function is hypothesized to influence this balance.
Purpose of the Study:
- To measure aortic reservoir function in children.
- To investigate the relationship between aortic reservoir function and cardiac blood supply-workload balance in pediatric subjects.
Main Methods:
- Aortic reservoir function was assessed using percent diastolic runoff (diastolic blood flow/total cardiac output).
- Cardiac blood supply-workload balance was evaluated via the subendocardial viability ratio (diastolic pressure time index/tension time index).
Main Results:
- Children exhibited a smaller percent diastolic runoff (51.7 ± 4.5%) compared to adults.
- Percent diastolic runoff positively correlated with age in children (r² = 0.32, p = 0.0052).
- A strong positive relationship was found between percent diastolic runoff and the subendocardial viability ratio (r² = 0.92, p < 0.0001).
Conclusions:
- Aortic reservoir function matures with age during childhood.
- Enhanced aortic reservoir function is strongly associated with improved cardiac blood supply-workload balance in children.
Abstract:
It has been reported that more than half of the ejected blood from the left ventricle is stored in the aorta during systole and expelled during diastole. One important organ that receives blood flow mainly during diastole is the heart. It is also reported that the cardiac blood supply-workload balance in small children is disadvantageous to the heart. Therefore, we measured the aortic reservoir function and examined the relationship between the aortic reservoir function and the cardiac blood supply-workload balance. The percent diastolic runoff, which is the percentage of the diastolic blood flow of the total cardiac output, was measured as the index of the aortic reservoir function. The subendocardial viability ratio-the ratio of the diastolic pressure time index (the blood supply to the heart) to the tension time index (implying the myocardial oxygen demand)-was investigated as an index of the cardiac blood supply-workload balance in children. The percent diastolic runoff was 51.7 ± 4.5%, smaller than that in adult. It had a significant positive relationship to age (r2 = 0.32, p = 0.0052). The subendocardial viability ratio was 100.8 ± 19.6% and had a strong relationship to the percent diastolic runoff (r2 = 0.92, p < 0.0001). The percent diastolic runoff had a positive relationship with age during childhood. The value had a strong impact on the cardiac blood supply-workload balance.
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