Compliance, mass, and shape of the canine left ventricle after global ischemia analyzed with two-dimensional echocardiography

Abstract

End-diastolic pressure (EDP)-volume (EDV) curves were constructed for the left ventricle (LV) in 10 dogs on cardiopulmonary bypass before and after 45 min of normothermic ischemic arrest. LVEDV and mass were calculated from three perpendicular two-dimensional echocardiographic sections using a Simpson's rule algorithm. The echocardiographic method employed was specially developed in earlier work for physiologic studies in dogs. Postmortem pressure-volume curves were measured for comparison by direct saline infusion into sealed ventricles. LVEDV was plotted against LVEDP (0–20 mm Hg) and data were analyzed by two-way analysis of variance and also by exponential curve fitting to the relation EDP = αℓ βEDV, where β is the derived exponential constant reflecting slope and thereby ventricular stiffness. Postischemic EDP-EDV curves shifted to the left and the β constant increased (β = 0.02 ± 0.005 (SE) vs 0.05 ± 0.01, P < 0.05). LV eccentricity, the ratio between long- and short-axis measurements, was unchanged (1.43 ± 0.05 vs 1.46 ± 0.06 postischemia, NS), but LV mass increased (105 ± 7 vs 128 ± 9 g postischemia, P < 0.001). Postischemic LV mass by echo was not significantly different from measured postmortem LV mass ( r = 0.87). The nonparallel alteration in the EDP-EDV curves, lack of change in LV shape (eccentricity), and increase in LV mass in the postischemic ventricle suggest that increased ventricular stiffness rather than direct encroachment by the edematous endocardium on chamber volume is responsible for postischemic changes in LV diastolic properties.