Gustav Smith
Associate professor
Hydraulic force is a novel mechanism of diastolic function which may contribute to decreased diastolic filling in HFpEF and facilitate filling in HFrEF
Author
Summary, in English
BACKGROUND: A hydraulic force generated by blood moving the atrio-ventricular plane is a novel mechanism of diastolic function. The direction and magnitude of the force is dependent on the geometrical relationship between the left atrium and ventricle and is measured as the short-axis atrio-ventricular area difference (AVAD). In short, the net hydraulic force acts from a larger area towards a smaller. It is currently unknown how cardiac remodeling affects this mechanism. The aim of the study was therefore to investigate this diastolic mechanism in patients with pathological or physiological remodeling.
METHODS: 70 subjects (n=11 heart failure with preserved ejection fraction (HFpEF), n=10 heart failure with reduced ejection fraction (HFrEF), n=7 signs of isolated diastolic dysfunction, n=10 hypertrophic cardiomyopathy (HCM), n=10 cardiac amyloidosis, n=18 triathletes and n=14 controls) were included. Subjects underwent Cardiac MR and short-axis images of the left atrium and ventricle were delineated. AVAD was calculated as ventricular area minus atrial area and used as an indicator of net hydraulic force.
RESULTS: At the onset of diastole, AVAD in HFpEF was median -9.2 cm2 versus -4.4 cm2 in controls, p=0.02). The net hydraulic force was directed towards the ventricle for both, but larger in HFpEF. HFrEF was the only group with a positive median value 11.6 cm2 and net hydraulic force was throughout diastole directed towards the atrium.
CONCLUSION: The net hydraulic force may impede cardiac filling throughout diastole in HFpEF, worsening diastolic dysfunction. In contrast, it may work favorably in patients with dilated ventricles and aid ventricular filling.
Department/s
- Human Movement: health and rehabilitation
- Lund Cardiac MR Group
- Pediatrisk radiologi
- Diagnostic Radiology, (Lund)
- Clinical Physiology (Lund)
- WCMM-Wallenberg Centre for Molecular Medicine
- Cardiovascular Research - Hypertension
- EpiHealth: Epidemiology for Health
- Heart Failure and Mechanical Support
- Cardiovascular Epigenetics
- Cardiology
- EXODIAB: Excellence of Diabetes Research in Sweden
- Molecular Epidemiology and Cardiology
Publishing year
2021-02-04
Language
English
Pages
993-1000
Publication/Series
Journal of Applied Physiology
Volume
130
Issue
4
Links
Document type
Journal article
Publisher
American Physiological Society
Topic
- Cardiac and Cardiovascular Systems
Status
Published
Research group
- Human Movement: health and rehabilitation
- Lund Cardiac MR Group
- Pediatrisk radiologi
- Cardiovascular Research - Hypertension
- Heart Failure and Mechanical Support
- Cardiovascular Epigenetics
- Molecular Epidemiology and Cardiology
ISBN/ISSN/Other
- ISSN: 1522-1601