Key result
End-stage heart failure is linked to lost contraction rate correlation between LV and RV.
Why the study?
Ventricular dyssynchrony often occurs in heart failure, but whether contractile property differences and mechanical synchrony exist between left and right ventricles in isolated human myocardium was unclear.
Are there differences in contractile properties and mechanical synchrony between left and right ventricular myocardium in healthy versus end-stage failing human hearts?
Observational (n=70)
Are there differences in contractile properties and mechanical synchrony between left and right ventricular myocardium in healthy versus end-stage failing human hearts?
In end-stage heart failure, isolated cardiac trabeculae exhibit interventricular mechanical dyssynchrony, with loss of the normal correlation in contractile kinetics between the left and right ventricles.
Interventricular dyssynchrony in end-stage HF warrants in vivo study; leaves open its role in progression or therapy.
Background: The left and right ventricles of the human heart differ in embryology, shape, thickness, and function. Ventricular dyssynchrony often occurs in cases of heart failure. Our objectives were to assess whether differences in contractile properties exist between the left and right ventricles and to evaluate signs of left/right ventricular mechanical synchrony in isolated healthy and diseased human myocardium. Methods: Myocardial left and right ventricular trabeculae were dissected from nonfailing and end-stage failing human hearts. Baseline contractile force and contraction/relaxation kinetics of the left ventricle were compared to those of the right ventricle in the nonfailing group (n=41) and in the failing group (n=29). Correlation analysis was performed to assess the mechanical synchrony between left and right ventricular myocardium isolated from the same heart, in nonfailing (n=41) and failing hearts (n=29). Results: The failing right ventricular myocardium showed significantly higher developed force (Fdev; P =0.001; d=0.98), prolonged time to peak ( P <0.001; d=1.14), and higher rate of force development ( P =0.002; d=0.89) and force decline ( P =0.003; d=0.82) compared to corresponding left ventricular myocardium. In healthy myocardium, a strong positive relationship was present between the left and right ventricles in time to peak (r=0.58, P <0.001) and maximal kinetic rate of contraction (r=0.63, P <0.001). These coefficients were much weaker, often nearly absent, in failing myocardium. Conclusions: At the level of isolated cardiac trabeculae, contractile performance, specifically of contractile kinetics, is correlated in the nonfailing myocardium between the left and right ventricles‚ but this correlation is significantly weaker, or even absent, in end-stage heart failure, suggesting an interventricular mechanical dyssynchrony.
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Mashali et al. (2023) conducted an observational in End-stage heart failure (n=70). End-stage heart failure vs. Nonfailing human hearts was evaluated on Developed force (Fdev) between failing right and left ventricular myocardium (d=0.98, p=0.001). End-stage heart failure was associated with a loss of the strong correlation in maximal kinetic rate of contraction between left and right ventricles seen in healthy myocardium (r=0.63, P<0.001).
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