Biomechanical and hemodynamic measures of right ventricular diastolic function: Translating tissue biomechanics to clinical relevance

Sae Jang, Rebecca R. Vanderpool, Reza Avazmohammadi, Eugene Lapshin, Timothy N. Bachman, Michael Sacks, Marc A. Simon

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background--Right ventricular (RV) diastolic function has been associated with outcomes for patients with pulmonary hypertension; however, the relationship between biomechanics and hemodynamics in the right ventricle has not been studied. Methods and Results--Rat models of RV pressure overload were obtained via pulmonary artery banding (PAB; control, n=7; PAB, n=5). At 3 weeks after banding, RV hemodynamics were measured using a conductance catheter. Biaxial mechanical properties of the RV free wall myocardium were obtained to extrapolate longitudinal and circumferential elastic modulus in low and high strain regions (E1 and E2, respectively). Hemodynamic analysis revealed significantly increased end-diastolic elastance (Eed) in PAB (control: 55.1 mm Hg/mL [interquartile range: 44.7-85.4 mm Hg/mL]; PAB: 146.6 mm Hg/mL [interquartile range: 105.8-155.0 mm Hg/mL]; P=0.010). Longitudinal E1 was increased in PAB (control: 7.2 kPa [interquartile range: 6.7-18.1 kPa]; PAB: 34.2 kPa [interquartile range: 18.1-44.6 kPa]; P=0.018), whereas there were no significant changes in longitudinal E2 or circumferential E1 and E2. Last, wall stress was calculated from hemodynamic data by modeling the right ventricle as a sphere: (stress = Pressure×radius/ 2×thickness). Conclusions--RV pressure overload in PAB rats resulted in an increase in diastolic myocardial stiffness reflected both hemodynamically, by an increase in Eed, and biomechanically, by an increase in longitudinal E1. Modest increases in tissue biomechanical stiffness are associated with large increases in Eed. Hemodynamic measurements of RV diastolic function can be used to predict biomechanical changes in the myocardium.

Original languageEnglish (US)
Article numbere006084
JournalJournal of the American Heart Association
Volume6
Issue number9
DOIs
StatePublished - Sep 1 2017

Keywords

  • Diastolic dysfunction
  • Pressure-volume relationship
  • Pulmonary hypertension
  • Right ventricle
  • Stiffness

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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