Hydraulic forces contribute to left ventricular diastolic filling

Research output: Contribution to journalArticle

Abstract

Myocardial active relaxation and restoring forces are known determinants of left ventricular (LV) diastolic function. We hypothesize the existence of an additional mechanism involved in LV filling, namely, a hydraulic force contributing to the longitudinal motion of the atrioventricular (AV) plane. A prerequisite for the presence of a net hydraulic force during diastole is that the atrial short-axis area (ASA) is smaller than the ventricular short-axis area (VSA). We aimed (a) to illustrate this mechanism in an analogous physical model, (b) to measure the ASA and VSA throughout the cardiac cycle in healthy volunteers using cardiovascular magnetic resonance imaging, and (c) to calculate the magnitude of the hydraulic force. The physical model illustrated that the anatomical difference between ASA and VSA provides the basis for generating a hydraulic force during diastole. In volunteers, VSA was greater than ASA during 75-100% of diastole. The hydraulic force was estimated to be 10-60% of the peak driving force of LV filling (1-3 N vs 5-10 N). Hydraulic forces are a consequence of left heart anatomy and aid LV diastolic filling. These findings suggest that the relationship between ASA and VSA, and the associated hydraulic force, should be considered when characterizing diastolic function and dysfunction.

Details

Authors
Organisations
External organisations
  • Karolinska Institutet
  • Skåne University Hospital
  • Washington University in St. Louis
  • KTH Royal Institute of Technology
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Physiology

Keywords

  • Biomechanical Phenomena, Diastole/physiology, Heart/diagnostic imaging, Humans, Magnetic Resonance Imaging, Models, Cardiovascular, Models, Theoretical, Ventricular Function, Left
Original languageEnglish
Pages (from-to)43505
JournalScientific Reports
Volume7
Publication statusPublished - 2017 Mar 3
Publication categoryResearch
Peer-reviewedYes