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a Departments of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan
b Departments of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Kuo-Chu Chang, Department of Physiology, College of Medicine, National Taiwan University, No. 1, Sec. 1, Jen-Ai Rd., Taipei, Taiwan E-mail: kcchang{at}ha.mc.ntu.edu.tw.
Decision Editor: John A. Faulkner, PhD
| Abstract |
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FOOD restriction (FR) not only increases the life span of rodents (1)(2), but also reduces the incidence of a broad spectrum of age-related pathologies, including cardiovascular diseases (3)(4)(5). There is evidence suggesting that FR may have the potential to maintain the cardiac neurotransmitter content and reuptake (6) and to alter the cellular calcium handling process (7). FR may increase the inotropic and chronotropic responsiveness of the isolated working heart preparation to ßadrenergic agnoists (7)(8). However, not all changes induced by FR retard the aging phenotypes. Both short- (9)(10) and long-term (11)(12) FR induce a shift in the myosin isoenzyme profile from the fast V1 isoform toward the slow V3 isoform, a shift that accentuates rather than retards the age-related changes.
The elastanceresistance model can be used to quantify the physical properties of the left ventricle, when the specific contractile proteins and the calcium metabolism have been changed (13)(14). This model to characterize the cardiac mechanics generates both Emax and Qmax; Emax is the maximal systolic elastance; Qmax is the theoretical maximal flow. Emax is considered the elasticity most sensitive to changes in contractile state and independent of preload, afterload, and heart rate in a given contractile state of the heart (15)(16)(17). These support the view that Emax serves in a given heart to quantify the intrinsic contractility of the left ventricle. The quantity in Qmax is the amount of outflow generated by the ventricle if it were to eject under zero load condition and is inversely related to the ventricular internal resistance (13)(18). An inverse relation between Qmax and percent slow myosin has been observed, suggesting that isomyosin composition is one of the determinants of ventricular resistive behavior (18). It is clear that the systolic elastance and resistance can describe two independent facets of the left ventricle as a mechanical pump (13).
Previous work from our laboratory has revealed that the intrinsic contractility of the left ventricle is depressed in rats at 24 months, and the ventricular internal resistance shows declines with age (14). The aim of the present study was to determine whether FR delays the development of age-related changes in left ventricular (LV) contractility and internal resistance in male Fischer 344 rats. Those two parameters that describe the cardiac mechanics were obtained by the use of fitting the elastanceresistance model. Although others have shown the reduced myocardial contractility with age (19) and the altered myocardial mechanics by FR (7), the novel aspect of this study is that the elastanceresistance model can describe the two independent facets of the left ventricle, affected by age and diet.
| Materials and Methods |
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Measurements of Hemodynamic Data
Each rat was anesthetized with sodium pentobarbital (35 mg/kg, i.p.). The femoral vein was cannulated for the administration of supplemental pentobarbital (30 mg/kg every 2 h). We monitored animal's rectal temperature and used a heater to maintain the rat's body temperature. Tracheotomy was performed to provide artificial ventilation with a tidal volume of 56 ml/kg and respiratory rate of 5070 breaths/min. The chest was opened through the right second intercostal space. An electromagnetic flow probe (model 100 series, internal circumference 810 mm, Carolina Medical Electronics, King, NC) was positioned around the ascending aorta to measure the pulsatile aortic flow. A Millar catheter with a high-fidelity pressure sensor (model SPC 320, size 2F, Millar Instruments, Houston, TX) was used to measure the pulsatile LV pressure. Before inserting the catheter, the pressure sensor was prewarmed in 37°C saline for at least 1 h. The catheter was inserted via the isolated right carotid artery into the left ventricle. After withdrawing the catheter from each rat, the technician reimmersed the catheter in the bath to check for baseline drift. At the end of the experiment, the pressure reading from the sensor submerged in the saline of less than 10 mm in depth was used as the zero pressure reference. The electrocardiogram (ECG) of lead II was recorded with a Gould ECG/Biotach amplifier (Gould Electronics, Cleveland, OH).
The analogue waveforms were sampled at 500 Hz using a 12-bit simultaneously sampling analog-to-digital (A/D) converter interfaced to a personal computer. Selection of signals of 510 beats at steady state was made on the basis of the following criteria: (i) recorded beats with optimal velocity profile that is characterized by a steady diastolic level, maximal systolic amplitude, and minimal late systolic negative flow; (ii) beats with a cardiac cycle length less than 5% different from the average value for all recorded beats; (iii) exclusion of ectopic and postectopic beats. The selected beats were averaged in the time domain, using the peak R wave of ECG as a fiducial point. The resulting LV pressure and ascending aortic flow signals were subjected to further analysis using the procedure previously described (20)(21). First, the isovolumic pressure curve is obtained from the instantaneous pressure of an ejecting contraction by a curve-fitting technique. Next, the elastanceresistance model with the estimated isovolumic pressure is applied to measure the systolic mechanical properties of the ventricular pump.
Estimation of the Isovolumic Pressure From an Ejecting Contraction
To estimate the isovolumic pressure curve Piso(t) from an ejecting beat, a nonlinear least-squares approximation technique derived by Sunagawa and colleagues (22) is used:
![]() | (1) |
is an angular frequency, c is a phase shift angle of the sinusoidal curve, and Pd is the LV end-diastolic pressure. The parameter Pisomax is the estimated peak isovolumic pressure that is the sum of Pidmax and Pd. Piso(t) is obtained by fitting the measured LV pressure curve segments from the end-diastolic pressure point to the peak positive dP/dt and from the pressure point of the peak negative dP/dt to the same level as the end-diastolic pressure of the preceding beat (23). The peak of the ECG R wave is used to identify the LV end-diastolic point.
Prediction of the LV Pressure Using an ElastanceResistance Model
Model-derived pressure of the left ventricle P(t) can be calculated by using the elastanceresistance model if the model parameters are previously identified (13)(24). The relationship between instantaneous LV pressure, flow, and isovolumic pressure can be written as follows:
![]() | (2) |
Both Veed and Qmax are the model parameters that remain to be determined by curve-fitting techniques. Campbell and colleagues (24) found that 2 can be used to fit the measured LV pressure of an ejecting beat very well, if the fitting interval is tej < t < tpisomax, where tej is the onset of ventricular ejection and tpisomax is the time of peak isovolumic pressure. The normalized root-mean-square ep is 3
![]() | (3) |
Fitness of the data generated by the model is judged by the magnitude of ep and by indices from a linear regression of the model-generated pressure P(i) on the measured pressure P(i). Two indices are used to evaluate the goodness-of-fit: (i) the coefficient of determination, r2, and (ii) the standard error of the estimate, SEE. We look for r2 to be close to 1 and for SEE to be on the order of less than 5% when expressed relative to the mean of pressure observations confined to the fitting interval (26).
Effective Arterial Volume Elastance as Arterial Chamber Property
The effective arterial volume elastance (Ea) could be calculated by the procedure previously described (14). In brief, the peak isovolumic pressure of the left ventricle at the end-diastolic volume is estimated by 1. The pressure-ejected volume loop can be obtained by the time integration of aortic flow and the measured LV pressure. Drawing a tangential line from the estimated peak isovolumic pressure to the right corner of the pressure-ejected volume loop yields a point referred to as the end-systolic equilibrium point (27). The pressure of the left ventricle at this end-systolic equilibrium point is the LV end-systolic pressure. Therefore, the slope of the end-systolic pressure versus stroke volume relation represents the effective arterial volume elastance.
Statistics
Results are expressed as means ± SE. Because cardiac output is significantly related to body shape, this variable was normalized to body weight when comparison was made between ad libitum (AL)-fed and food-restricted rats. We also normalized Emax for LV muscle mass, i.e., Emax n = Emax/LV weight, due to alteration in LV mass by age and diet. A two-way analysis of variance (ANOVA) was employed to determine the effects of FR on cardiac mechanics in middle-aged and senescent rats. Simple effects analysis was used when significant interaction between diet and age occurred. Significant differences were assumed at the level of p < .05.
| Results |
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The results of fitting the elastanceresistance model to LV pressure showed little distinction between the model-generated and measured signals. The averaged values for ep as an indication of the quality of fit was 0.0049 ± 0.0004, for r2 was 0.9844 ± 0.0017, and for SEE was 2.69 ± 0.20%. These data suggest that the elastanceresistance model may generate Emax and Qmax with good quality to describe the systolic mechanical behavior of the ventricular pump.
Fig. 1Fig. 2Fig. 3 show the effects of age and diet on cardiac mechanics in terms of the maximal systolic elastance, Emax, and the theoretical maximal flow, Qmax. Neither age nor diet affected the estimated peak isovolumic pressure, Pisomax, nor was there an Age x Diet interaction for Pisomax (upper panel, Fig. 1). A significant interaction between the effects of age and diet in their effects on the effective LV end-diastolic volume, Veed, was detected (lower panel, Fig. 1). While producing a rise in Veed in middle-aged rats, FR exhibited a decline in Veed in senescent rats. Moreover, Veed increased with advancing age in AL-fed rats but not FR rats.
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| Discussion |
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As mentioned earlier, the maximal systolic elastance, Emax, is determined by the ratio of Pisomax to Veed. Neither age nor diet affected Pisomax, nor was there an interaction by Age x Diet for Pisomax. As a result, Veed is the predominant factor responsible for the value of Emax. An age-related increase in Veed occurs in AL-fed rats (lower panel, Fig. 1), giving rise to the decline with advancing age in Emax (upper panel, Fig. 2). The finding that this age-related increase in Veed is alleviated by FR in this study is important. FR results in a fall in Veed in senescent rats, showing a little but not a significant rise in Emax. By contrast, FR produces an increase in Veed in middle-aged rats, exhibiting the Emax similar to that as seen in senescent rats with food restriction. These data suggest that there is no age-related change in the elastic chamber property of the left ventricle in FR rats. To account for differences in LV muscle mass by age and diet (Table 1 ), Emax is normalized by dividing with LV weight (i.e., Emaxn = Emax/LV weight) (13). In this study, we compare Emaxn among the four groups to determine how great the effects of FR are on delaying the development of changes in LV intrinsic contractility with age.
The properties of the contractile unit along with the activation process (i.e., availability of Ca2+) may profoundly determine the intrinsic contractility of the myocardium (13)(16). There is evidence suggesting that the abnormalities in contractile proteins and calcium metabolism occur in an aging heart and contribute to the mechanical defects of the heart with age (8)(9). In this report, only in AL-fed rats, the intrinsic contractility of the heart is depressed in rats at 24 months, as evidenced by the reduction in Emaxn. This may be due to the abnormalities in calcium metabolism in rats with advancing age. Many reports in the literature have shown that there is an age-related decline in the responsiveness of the heart to ßadrenergic stimulation (7)(8)(28). The implication of this phenomenon is the changes in the intracellular calcium handling with age (7)(8). Although the mechanism underlying the effect of diet on the ßadrenergic system is not known, the age-related decline in cardiac ßadrenergic responsiveness can be retarded by FR (7)(8). Therefore, we treat rats with FR for 6 months to establish whether the changes in cardiac contractility are preventable. FR, as manifested by the increase in Emaxn, delays the reduction in myocardial contractility that occurred between 18 and 24 months of age in AL-fed rats. As suggested by others (19)(29), FR may increase the availability of calcium ion to enhance the intrinsic contractility of the left ventricle in rats with age.
Of the biochemical changes in the contractile machinery, the most prominent event in the aging myocardium is the shift of the myosin isoenzyme profile from the fast V1 isoform toward the slow V3 isoform (30)(31). It has been suggested that there is an inverse relation between Qmax and percent slow myosin composition (18). The quantity in Qmax is inversely influenced by Ea, suggesting that Ea is also one of the determinants of ventricular resistive behavior (14)(21). Our previous work has suggested that the age-related decline in Ea, but not the shift of myosin isoenzyme profile, may be the predominant factor responsible for the increased Qmax with age (14). Much evidence has shown that FR accentuated rather than retarded the age-related shift in myosin isoenzyme profile from the V1 toward the V3 isoform (9)(10)(12). One would expect that this isoenzyme shift by FR might cause a fall in Qmax and then a rise in ventricular internal resistance. By contrast, the trend in diminishing Ea by FR was supposed to contribute to an increase in Qmax. Herein, Qmax is unaffected by diet, suggesting that FR may have no impact on the age-related changes in ventricular internal resistance. It is possible that the effects of FR on myosin isoenzyme profile and arterial chamber properties counterbalance each other to cause no alterations in Qmax at both ages.
When considering the integrated cardiovascular function, one requires not only information about cardiac mechanics but also knowledge of vascular dynamics. In this study, we are treating the arterial system like an elastic chamber with Ea, just as we treat the ventricle like an elastic chamber with Emax. Thus, the ventricular performance can be determined by the chamber properties of both the ventricle and the vasculature, when the ventricle is coupled to its arterial load (32). As mentioned earlier, FR prevents the reduction in myocardial contractility that occurred between 18 and 24 months of age in AL-fed rats. However, FR does not affect the age-related changes in ventricular internal resistance. Moreover, neither HR nor Ea is affected by diet at both ages. These data suggest that FR may reserve the ventricular function in an aging heart, maintaining normal blood flow essential for the metabolic needs of tissues and/or organs.
Some limitations of the current study deserve consideration. First of all, the isovolumic beats were not obtained by occluding the ascending aorta at the end of diastole; instead, the isovolumic pressure was estimated by the use of curve fitting of the ejecting beat. With a shorter cardiac cycle length, the estimated isovolumic beat was shown to have the Pisomax quite close to the Pisomax actually measured by occluding the ascending aorta in diastole (22). The advantage of this single-beat estimation technique is that the integrated nature of the cardiodynamics can be measured without occluding the ascending aorta at the end of diastole.
Second, Emax, rather than other indices such as the maximal first derivative of LV pressure with respect to time, was used to quantify the intrinsic contractility of the left ventricle in this study. The ideal index of contractility is: (a) sensitive to alteration in inotropic state, (b) insensitive to changes in preload and afterload, (c) independent of heart rate, and (d) independent of cardiac size (15). Much evidence has shown that Emax is independent of preload, afterload, and heart rate in a given contractile state of the heart (15)(16)(17). Hunter and colleagues (16) demonstrated that Emax is considered the elasticity most sensitive to changes in contractile state, though it is not so sensitive as the pressurevolume ratio derived by Suga and colleagues (17). Thus, Emax may be used as a measure of LV intrinsic contractility in terms of the sensitivity and the specificity.
Third, the elastanceresistance model does not perfectly describe the pumping mechanical behavior of the left ventricle. Hunter and colleagues (16)(33), using the flowpulse response technique, demonstrated that, besides elastance and resistance, there are at least two or more processes, such as the volume influence factor and deactivation factor, involved in the description of the mechanical properties of the ventricular pump. Moreover, Campbell and colleagues (34) found that the elastanceresistance model failed to describe the instantaneous LV pumping behavior, especially during the late ejection period and from the predictive point of view. However, in an earlier article (24), they showed that the elastanceresistance model could be used to fit the measured LV pressure of an ejection beat very well, if the fitting interval was from the onset of ventricular ejection to the time of peak isovolumic pressure. Shroff and colleagues (13) believe that the elastanceresistance model is useful to quantify LV systolic mechanical properties, provided one clearly understands its limitations.
In summary, we determined the effects of FR on cardiac mechanics in middle-aged and senescent rats in terms of the systolic elastance and resistance. The most striking findings of this study are that FR prevents the reduction in myocardial contractility that occurred between 18 and 24 months of age in AL-fed rats. However, FR does not affect the age-related changes in ventricular internal resistance. FR may reserve the ventricular function in an aging heart, maintaining normal blood flow essential for the metabolic needs of tissues and/or organs.
| Acknowledgments |
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Received March 30, 2000
Accepted September 14, 2000
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