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What is the Clinical Significance of Ventricular Mural Antagonism?

Lunkenheimer, PP and Niederer, P and Stephenson, RS and Redmann, K and Batista, RV and Smerup, M and Anderson, RH (2017) What is the Clinical Significance of Ventricular Mural Antagonism? European Journal of Cardio-Thoracic Surgery. ISSN 1010-7940

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Abstract

Recent morphological studies provide evidence that the ventricular walls are arranged as a 3D meshwork of aggregated cardiomyocyte chains, exhibiting marked local structural variations. In contrary to previous findings, up to two-fifths of the chains are found to have a partially transmural alignment, thus deviating from the prevailing tangential orientation. Upon contraction, they produce, in addition to a tangential force, a radial force component that counteracts ventricular constriction and aids widening of the ventricular cavity. In experimental studies, we have provided evidence for the existence of such forces, which are auxotonic in nature. This is in contrast to the tangentially aligned myocytes that produce constrictive forces, which are unloading in nature. The ventricular myocardium is, therefore, able to function in an antagonistic fashion, with the prevailing constrictive forces acting simultaneously with a dilatory force component. The ratio of constrictive to dilating force varies locally according to the specific mural architecture. Such antagonism acts according to local demands to preserve the ventricular shape, store the elastic energy that drives the fast late systolic dilation and apportion mural motion to facilitate the spiralling nature of intracavitary flow. Intracavitary pressure and flow dynamics are thus governed concurrently by ventricular constrictive and dilative force components. Antagonistic activity, however, increases deleteriously in states of cardiac disease, such as hypertrophy and fibrosis. ß-blockade at low dosage acts selectively to temper the auxotonic forces.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Cardio-Thoracic Surgery following peer review. The version of record Paul P Lunkenheimer, Peter Niederer, Robert S Stephenson, Klaus Redmann, Randas V Batista, Morten Smerup, Robert H Anderson; What is the clinical significance of ventricular mural antagonism?, European Journal of Cardio-Thoracic Surgery, , ezx382, is available online at: http://dx.doi.org/10.1093/ejcts/ezx382
Uncontrolled Keywords: 1102 Cardiovascular Medicine And Haematology
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: Oxford University Press (OUP)
Date Deposited: 17 Nov 2017 12:55
Last Modified: 17 Nov 2017 12:55
DOI or Identification number: 10.1093/ejcts/ezx382
URI: http://researchonline.ljmu.ac.uk/id/eprint/7571

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