Mulligan Lawrence J, Thrash Julian, Mitrev Ludmil, Ewert Daniel, Hill Jeffrey C
Department of Anesthesiology, Cooper University Hospital, Camden, NJ 08103, USA.
Cooper Medical School, Rowan University, Camden, NJ 08103, USA.
J Cardiovasc Dev Dis. 2025 Apr 22;12(5):163. doi: 10.3390/jcdd12050163.
Vascular aging is associated with a loss of aortic compliance (C), which results in increased left ventricular pressure-volume area (PVA), stroke work (SW) and myocardial oxygen consumption (MVO). Myocardial efficiency (MyoEff) is derived from the PVA and MVO construct, which includes potential energy (PE). However, the SW/MVO ratio does not include PE and provides a more accurate physiologic measure.
We used a modified computational model (CM) to assess PVA and SW and calculate MVO using a pressure-work index (e MVO), to derive MyoEff-PVA and MyoEff-SW metrics. Phase I evaluated five levels of human C from normal (N) to stiff (S) at 80 bpm, and Phase II evaluated two levels of C (N and S) at three heart rates (60, 100, and 140 bpm).
During Phase I, MyoEff-PVA increased from 20.7 to 31.2%, and MyoEff-SW increased from 14.8 to 18.9%. In Phase II, during the N setting coupled with increases in the heart rate, the MyoEff-PVA decreased from 29.4 to 14.8 to 9.5%; the MyoEff-SW also decreased from 22.5 to 10.3 to 5.9%. As expected, during the S setting, MyoEff-PVA decreased from 45.5 to 22.9 to 14.8; a similar effect occurred with the MyoEff-SW, demonstrating a decrease from 29.9 to 13.9 to 7.9%, respectively.
The CM provided insights into a simple and clinically relevant calculation for assessing MyoEff. The agreement on the CM metrics aligns with studies conducted previously in the clinical setting.
血管老化与主动脉顺应性（C）丧失有关，这会导致左心室压力-容积面积（PVA）、每搏功（SW）和心肌耗氧量（MVO）增加。心肌效率（MyoEff）源自PVA和MVO结构，其中包括势能（PE）。然而，SW/MVO比值不包括PE，可提供更准确的生理学测量值。
我们使用改进的计算模型（CM）来评估PVA和SW，并使用压力-功指数（e MVO）计算MVO，以得出MyoEff-PVA和MyoEff-SW指标。第一阶段在80次/分钟时评估了从正常（N）到僵硬（S）的五个水平的人体C，第二阶段在三个心率（60、100和140次/分钟）下评估了两个水平的C（N和S）。
在第一阶段，MyoEff-PVA从20.7%增加到31.2%，MyoEff-SW从14.8%增加到18.9%。在第二阶段，在N状态下随着心率增加，MyoEff-PVA从29.4%降至14.8%再降至9.5%；MyoEff-SW也从22.5%降至10.3%再降至5.9%。正如预期的那样，在S状态下，MyoEff-PVA从45.5%降至22.9%再降至14.8%；MyoEff-SW也出现类似效果，分别从29.9%降至13.9%再降至7.9%。
该计算模型为评估MyoEff提供了一种简单且与临床相关的计算方法。计算模型指标的一致性与先前在临床环境中进行的研究一致。
