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Reduced right atrial contractile force in patients with left ventricular diastolic dysfunction: A study in human atrial fibers—contractile force and diastolic dysfunction

Reduced right atrial contractile force in patients with left ventricular diastolic dysfunction: A study in human atrial fibers—contractile force and diastolic dysfunction

Authors :
Constanze Bening
Anjuli Sikand
Lars Oliver Conzelmann
Nicole Stumpf
Christian-Friedrich Vahl
Source :
Asian Journal of Surgery, Vol 40, Iss 1, Pp 23-28 (2017)
Publication Year :
2017
Publisher :
Elsevier, 2017.

Abstract

Background/Objective: The aim of our study was to evaluate right heart contractile force in patients with diastolic dysfunction (DD) with preserved left heart ejection fraction undergoing cardiac surgery. We examined the contractile properties of skinned human fibers obtained from the right auricle in two groups (DD and controls). Methods: Right atrial tissue from 64 patients, who were undergoing cardiac surgery, were collected before extracorporal circulation. Tissue was conserved and prepared as “skinned fibers”. We exposed the dissected fibers to increasing calcium concentrations and recorded the force values. Results: Patients with DD develop significantly less force at middle and higher calcium concentrations pCa 4.0: DD 2.58 ± 0.4 mN, controls 5.32 ± 0.4 mN, p = 0.02; pCa 5.5: DD 1.14 ± 0.3 mN, controls 1.45 ± 0.3 mN, p = 0.03. DD significantly correlates with left ventricular hypertrophy (LVH; p = 0.03). DD did not significantly occur more often in patients with mitral valve insufficiency, aortic insufficiency or stenosis, or coronary heart disease (all p > 0.10). LVH, which was associated with DD, correlated significantly with mitral valve prolapse (p = 0.05), aortic valve stenosis (p = 0.02), and mitral valve insufficiency (p = 0.03). Conclusion: Contractile force is significantly reduced in right atrial skinned human fibers with DD. DD is significantly associated with LVH, but emerges independently from underlying pathologies like valve diseases or coronary heart disease. This underlines the hypothesis that impairment of contractile capacity directly results from DD—independent from volume or pressure overload due to valvular or ischemic heart disease.

Details

Language :
English
ISSN :
10159584
Volume :
40
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Asian Journal of Surgery
Publication Type :
Academic Journal
Accession number :
edsdoj.3ff94e5640994377a8ac3487d8946c47
Document Type :
article
Full Text :
https://doi.org/10.1016/j.asjsur.2015.07.005