Arterial wave propagation phenomena, ventricular work, and power dissipation.

Abstract

The effects of wave propagation phenomena, namely global reflection coefficient (gamma G[omega]) and pulse wave velocity (Cph), are studied in a model of the coupled left ventricle/arterial system. The left ventricle consists of a time-varying elastance, while the arterial system is modeled as a single, uniform, elastic tube terminating in a complex load. Manipulation of model parameters allowed for the precise control of gamma G(omega) and Cph independent of each other, peripheral resistance, and characteristic impedance. Reduction of gamma G(omega) and Cph were achieved through increases in load compliance and tube compliance, respectively. The equations describing the system were solved for left ventricular and aortic pressures and aortic flow. From these, stroke volume (SV), left ventricular stroke work (SW), and steady (Ws), oscillatory (Wo), and total power dissipation (Wt) in the arterial system were calculated. An index of arterial system efficiency was the ratio Wo/Wt (%Wo), with lower values indicating higher efficiency. Reduction of gamma G(omega) yielded initial increases in Ws, while Wo increased for the entire range of gamma G(omega), resulting in increased %Wo. This reduced efficiency is imposed on the ventricle, resulting in increased SW without increased SV. On the other hand, decreased Cph yielded in a steady increase in Ws and a biphasic response in Wo, resulting in reduced %Wo for most of the range of reduced Cph. These results suggest that differential effects on arterial system efficiency can result from reductions of gamma G(omega) and Cph. In terms of compliance, changes in arterial compliance can have different effects on efficiency, depending on where the compliance change takes place. Reasons for these results are suggested, and the role of distributed compliances is raised as a new problem.