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Histologic and biochemical correlates of left ventricular chamber dynamics in man
Insights
Left ventricular function in humans is linked to high-energy phosphate levels in heart muscle. Adenosine triphosphate/protein ratio correlates with systolic and diastolic function, but not fibrosis or cell size.
Area of Science:
- Cardiology
- Biochemistry
- Histology
Background:
- Left ventricular (LV) chamber dynamics are crucial for cardiac function.
- Understanding the relationship between myocardial characteristics and LV function is vital for diagnosing and treating heart conditions.
Purpose of the Study:
- To investigate the correlation between human left ventricular chamber dynamics and quantitative histologic and biochemical analysis of endomyocardial biopsy samples.
Main Methods:
- Simultaneous measurement of pressure-volume relations using gated radionuclide angiography, echocardiography, and micromanometer pressure.
- Quantitative histologic analysis (percent fibrosis, cell diameter) and adenosine triphosphate (ATP) content measurement from LV biopsy specimens.
- Comparison of derived chamber dynamics with biopsy data.
Main Results:
- Systolic function measures correlated linearly with high-energy phosphate content.
- ATP/protein ratio showed strong correlations with ejection fraction (r=0.81), peak ejection rate (r=-0.73), and peak positive dP/dt (r=0.79).
- Diastolic function showed variable correlations with ATP/protein ratio, relating to active relaxation and peak filling rate, but not passive filling or fibrosis/cell size.
Conclusions:
- High-energy phosphate content, specifically ATP/protein ratio, is a significant biochemical marker for left ventricular systolic and diastolic function.
- Histologic factors like fibrosis and cell diameter do not correlate with these functional parameters.
- Biochemical analysis of myocardial tissue offers valuable insights into cardiac performance.
Abstract:
To investigate the relation between left ventricular chamber dynamics in humans and the quantitative analysis of the histologic and biochemical characteristics of left ventricular endomyocardial biopsy material, 15 patients with a wide range of ventricular function were studied. The pressure-volume relation was determined using simultaneous gated radionuclide angiography, echocardiography and micromanometer pressure. The derived chamber dynamics were then compared with quantitative histologic data (percent fibrosis and cell diameter) and adenosine triphosphate content measurements obtained from the left ventricular biopsy specimen obtained at the time of the pressure-volume studies. The measures of systolic function correlated linearly with high energy phosphate content. The adenosine triphosphate/protein ratio (nanomoles) was shown to parallel ejection fraction (r = 0.81), peak ejection rate (r = -0.73) and peak positive maximal rate of rise in left ventricular pressure (dP/dt) (r = 0.79). No correlation was observed between these variables and the percent fibrosis or cell diameter. Variable results were found in comparing the diastolic properties of the left ventricle with the biopsy data. In general, the high energy phosphate content correlated with measures of active relaxation, but not with the passive filling characteristics of the left ventricle. The adenosine triphosphate/protein ratio was linearly related to peak negative dP/dt (r = -0.74) and the peak filling rate (r = 0.76) but correlated less well with other measures of active and passive diastolic filling. No correlation was found between any diastolic variable and the percent fibrosis or cell diameter.(ABSTRACT TRUNCATED AT 250 WORDS)