Related Experiment Video
Updated: May 15, 2025
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Differential impact of ventricular-arterial coupling on left ventricular function in patients with acute myocardial
Hae Eun Yun1, Seung-Jae Joo2, Geum Ko1
1Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea.
Insights
Ventricular-arterial coupling (VAC) impacts heart function differently based on left ventricular ejection fraction (EF) after acute myocardial infarction. Preserved EF shows stronger links between VAC and cardiac function than reduced EF.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Biomedical Engineering
Background:
- Ventricular-arterial coupling (VAC) is vital in heart failure development, particularly in coronary artery disease.
- The relationship between VAC and left ventricular (LV) function can differ based on LV systolic function.
- This study examines VAC and LV function in acute myocardial infarction (AMI) patients, categorized by ejection fraction (EF).
Purpose of the Study:
- To investigate the relationship between ventricular-arterial coupling (VAC) and left ventricular (LV) function in patients with acute myocardial infarction (AMI).
- To stratify the analysis based on left ventricular ejection fraction (EF) status (reduced vs. preserved).
Main Methods:
- Echocardiography was used to assess LV volumes, systolic, and diastolic function.
- Effective arterial elastance (EA) and LV end-systolic elastance were calculated.
- Central aortic pressure and flow waveforms were measured using applanation tonometry and Fourier transformation to determine characteristic impedance (Zc).
Main Results:
- Eighty-five AMI patients were divided into reduced EF (<50%, 27 patients) and preserved EF (≥50%, 58 patients) groups.
- In preserved EF, E' velocity correlated with VAC (P=0.008), and LV global longitudinal strain associated with VAC (P<0.001), EA index (P<0.001), and Zc (P=0.018).
- These associations were not significant in the reduced EF group.
Conclusions:
- Ejection fraction status significantly influences the interplay between hemodynamic parameters and LV function in AMI patients.
- The findings suggest that ventricular-arterial coupling dynamics differ between preserved and reduced LV systolic function in the context of AMI.
Background:
Ventricular-arterial coupling (VAC) plays a crucial role in the initiation and progression of heart failure in patients with coronary artery disease. The influence of VAC on left ventricular (LV) function may vary depending on LV systolic function. This study investigated the relationship between VAC and LV function in patients with acute myocardial infarction (AMI), stratified by ejection fraction (EF).
Methods:
Echocardiographic indices of LV volumes, systolic function, and diastolic function were measured using standard techniques. Effective arterial elastance (EA) was calculated based on stroke volume derived from the LV outflow waveform. Effective LV end-systolic elastance was determined using the single-beat method. The central aortic pressure waveform was recorded via applanation tonometry. Characteristic impedance (Zc) of the aortic root was calculated using Fourier transformation of both aortic pressure and flow waveforms.
Results:
A total of 85 patients (mean age, 58.5 ± 10.6 years) with AMI were enrolled. They were classified into two groups: those with reduced EF (< 50%, 27 patients) and those with preserved EF (≥ 50%, 58 PATIENTS). In the adjusted linear regression analysis, E' velocity was significantly associated with VAC (β = -0.310, P = 0.008) in the preserved EF group but not in the reduced EF group. LV global longitudinal strain showed significant positive associations with VAC (β = 0.505, P < 0.001), EA index (β = 0.536, P < 0.001), and Zc (β = 0.344, P = 0.018) exclusively in the preserved EF group.
Conclusions:
The distinct influence of EF status on the relationships between hemodynamic parameters and LV diastolic and systolic functions suggests a differential interplay between arterial and ventricular dynamics depending on LV systolic function.
