Key result
Increasing arterial compliance in a mock circulation increased stroke volume by up to 6% in systolic dysfunction and decreased systolic work by 4% and 11% in systolic and diastolic dysfunction.
Why the study?
Does an increase in arterial compliance affect left ventricular performance differently in systolic versus diastolic dysfunction in a mock circulation model?
Does an increase in arterial compliance affect left ventricular performance differently in systolic versus diastolic dysfunction in a mock circulation model?
Changes in arterial compliance exert distinct mechanical effects on left ventricular performance depending on whether the underlying dysfunction is systolic or diastolic.
Answers are grounded in this paper and cite their sources.
Findings from this mock model warrant clinical caution; leaves open differential arterial compliance effects in human systolic versus diastolic dysfunction.
Arterial compliance (AC) is expected to play a major role on cardiac efficacy by acute or long-term mechanisms. The aim of this study was to investigate the purely mechanical effect of AC on left ventricular (LV) performance, for different conditions of LV dysfunction (systolic versus diastolic). A hydraulic, Windkessel model of systemic circulation was used. LV function and aortic flow were simulated using a left ventricular assist device (LVAD). Two cases of LV dysfunction were simulated: Case A, systolic and Case B, diastolic dysfunction. In Case A, AC increased from 1.14 to 2.85 ml mm Hg(-1) leading to an increase in LVAD stroke volume up to 6%, while no significant effect was observed in Case B. LVAD systolic work was decreased by 4% in systolic and by 11% in diastolic LVAD dysfunction. The purely mechanical effect of AC changes on LVAD function was different between systolic and diastolic dysfunction. It might be expected that even an acute reduction in arterial stiffness could enhance LV performance by different means in systolic compared to diastolic dysfunction.
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Papaioannou et al. (2003) studied systolic and diastolic left ventricular dysfunction. Arterial compliance increase vs. Baseline arterial compliance was evaluated on LVAD stroke volume and systolic work. Increasing arterial compliance in a mock circulation increased stroke volume by up to 6% in systolic dysfunction and decreased systolic work by 4% and 11% in systolic and diastolic dysfunction.
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