Hydraulic forces contribute to left ventricular diastolic filling
2016 (English)Manuscript (preprint) (Other academic)
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 the same order of magnitude as the peak driving force of LV (1-3N vs 5-10N). 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 resulting hydraulic forces, should be considered when characterizing diastolic function and dysfunction.
Place, publisher, year, edition, pages
Medical and Health Sciences
Research subject Medical Technology
IdentifiersURN: urn:nbn:se:kth:diva-196532OAI: oai:DiVA.org:kth-196532DiVA: diva2:1046781
QC 201611152016-11-152016-11-152016-11-15Bibliographically approved