Heart filling exceeds emptying during late ventricular systole in patients with systolic heart failure and healthy subjects – a cardiac MRI study
Carlsson, Marcus LU ; Ugander, Martin LU ; Kanski, Mikael LU ; Borgquist, Rasmus LU
; Ekelund, Ulf
LU
and Arheden, Håkan
LU
(2019)
In Clinical Physiology and Functional Imaging
39(3).
p.192-200
- Abstract
Background: Total heart volume (THV) within the pericardium is not constant throughout the cardiac cycle and THV would intuitively be lowest at end systole. We have, however, observed a phase shift between ventricular outflow and atrial inflow which causes the minimum THV to occur before end systole. The aims were to explain the mechanism of the late-systolic net inflow to the heart and determine whether this net inflow is affected by increased cardiac output or systolic heart failure. Methods and Results: Healthy controls (n = 21) and patients with EF<35% (n = 14) underwent magnetic resonance imaging with flow measurements in vessels to and from the heart, and this was repeated in nine controls during 140 μgram kg−1... (More)
Background: Total heart volume (THV) within the pericardium is not constant throughout the cardiac cycle and THV would intuitively be lowest at end systole. We have, however, observed a phase shift between ventricular outflow and atrial inflow which causes the minimum THV to occur before end systole. The aims were to explain the mechanism of the late-systolic net inflow to the heart and determine whether this net inflow is affected by increased cardiac output or systolic heart failure. Methods and Results: Healthy controls (n = 21) and patients with EF<35% (n = 14) underwent magnetic resonance imaging with flow measurements in vessels to and from the heart, and this was repeated in nine controls during 140 μgram kg−1 min−1 adenosine infusion. Minimum THV occurred 78 ± 6 ms before end of systolic ejection (8 ± 1% of the cardiac cycle) in controls. The late-systolic net inflow was 12·3 ± 1·1 ml or 6·0 ± 0·5% of total stroke volume (TSV). Cardiac output increased 66 ± 8% during adenosine but late-systolic net inflow to the heart did not change (P = 0·73). In patients with heart failure, late-systolic net inflow of the heart′s left side was lower (3·4 ± 0·5%) compared to healthy subjects (5·3 ± 0·6%, P = 0·03). Conclusions: Heart size increases before end systole due to a late-systolic net inflow which is unaffected by increased cardiac output. This may be explained by inertia of blood that flows into the atria generated by ventricular systole. The lower late-systolic net inflow in patients with systolic heart failure may be a measure of decreased ventricular filling due to decreased systolic function, thus linking systolic to diastolic dysfunction.
(Less)
- author
- Carlsson, Marcus
LU
; Ugander, Martin
LU
; Kanski, Mikael
LU
; Borgquist, Rasmus
LU
; Ekelund, Ulf
LU
and Arheden, Håkan
LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cardiac output, cardiac pumping, diastolic dysfunction
- in
- Clinical Physiology and Functional Imaging
- volume
- 39
- issue
- 3
- pages
- 192 - 200
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- scopus:85057974000
- pmid:30506862
- ISSN
- 1475-0961
- DOI
- 10.1111/cpf.12555
- language
- English
- LU publication?
- yes
- id
- 7b37519c-21d1-46e9-8d72-76117af27cc9
- date added to LUP
- 2019-01-02 09:37:57
- date last changed
- 2024-06-25 03:44:03
@article{7b37519c-21d1-46e9-8d72-76117af27cc9,
abstract = {{<p>Background: Total heart volume (THV) within the pericardium is not constant throughout the cardiac cycle and THV would intuitively be lowest at end systole. We have, however, observed a phase shift between ventricular outflow and atrial inflow which causes the minimum THV to occur before end systole. The aims were to explain the mechanism of the late-systolic net inflow to the heart and determine whether this net inflow is affected by increased cardiac output or systolic heart failure. Methods and Results: Healthy controls (n = 21) and patients with EF<35% (n = 14) underwent magnetic resonance imaging with flow measurements in vessels to and from the heart, and this was repeated in nine controls during 140 μgram kg<sup>−1</sup> min<sup>−1</sup> adenosine infusion. Minimum THV occurred 78 ± 6 ms before end of systolic ejection (8 ± 1% of the cardiac cycle) in controls. The late-systolic net inflow was 12·3 ± 1·1 ml or 6·0 ± 0·5% of total stroke volume (TSV). Cardiac output increased 66 ± 8% during adenosine but late-systolic net inflow to the heart did not change (P = 0·73). In patients with heart failure, late-systolic net inflow of the heart′s left side was lower (3·4 ± 0·5%) compared to healthy subjects (5·3 ± 0·6%, P = 0·03). Conclusions: Heart size increases before end systole due to a late-systolic net inflow which is unaffected by increased cardiac output. This may be explained by inertia of blood that flows into the atria generated by ventricular systole. The lower late-systolic net inflow in patients with systolic heart failure may be a measure of decreased ventricular filling due to decreased systolic function, thus linking systolic to diastolic dysfunction.</p>}},
author = {{Carlsson, Marcus and Ugander, Martin and Kanski, Mikael and Borgquist, Rasmus and Ekelund, Ulf and Arheden, Håkan}},
issn = {{1475-0961}},
keywords = {{cardiac output; cardiac pumping; diastolic dysfunction}},
language = {{eng}},
number = {{3}},
pages = {{192--200}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Clinical Physiology and Functional Imaging}},
title = {{Heart filling exceeds emptying during late ventricular systole in patients with systolic heart failure and healthy subjects – a cardiac MRI study}},
url = {{http://dx.doi.org/10.1111/cpf.12555}},
doi = {{10.1111/cpf.12555}},
volume = {{39}},
year = {{2019}},
}