Developmental modulation of myocardial mechanics: Age- and growth-related alterations in afterload and contractility
Somatic growth is associated with alterations in myocardial mechanics in children with heart disease and in most animal models of congenital heart disease. However, the effect of age and body size on myocardial contractility and loading conditions in normal infants and children is not known. Therefo...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1992-03, Vol.19 (3), p.619-629 |
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| creator | Colan, Steven D. Parness, Ira A. Spevak, Philip J. Sanders, Stephen P. |
| description | Somatic growth is associated with alterations in myocardial mechanics in children with heart disease and in most animal models of congenital heart disease. However, the effect of age and body size on myocardial contractility and loading conditions in normal infants and children is not known. Therefore, 256 normal children aged 7 days to 19 years (34% |
| doi_str_mv | 10.1016/S0735-1097(10)80282-7 |
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Ventricular shape, assessed as the major/minor axis ratio, and the circumferential/meridional stress ratio were found to be invariant with growth. The ratio of posterior wall thickness to minor axis dimension did not change with age, despite the normal age-related increase in blood pressure. The increase in pressure despite unvarying ventricular shape and wall thickness/dimension ratio resulted in a substantial increase in wall stress that was most dramatic during the first few years of life. In association with the increase in afterload, systolic function decreased with age. However, the age-related decrease in the velocity of shortening was greater than that expected from the increase in afterload alone, indicating a higher level of contractility in infants and children during the first years of life than in older subjects.
The process of normal growth and development, similar to that in children with heart disease, is associated with a rapid decrease in the trophic response to hemodynamic loads, resulting in an age-associated increase in wall stress. There is a similar but somewhat more rapid decrease in contractility, with the highest values seen in the youngest patients.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(10)80282-7</identifier><identifier>PMID: 1538019</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aging - physiology ; Biological and medical sciences ; Blood Pressure - physiology ; Cardiovascular system ; Child ; Child, Preschool ; Echocardiography ; Female ; Heart - growth & development ; Heart - physiology ; Heart Ventricles - anatomy & histology ; Humans ; Infant ; Investigative techniques of hemodynamics ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Myocardial Contraction - physiology ; Stress, Mechanical ; Stroke Volume - physiology ; Ventricular Function, Left - physiology</subject><ispartof>Journal of the American College of Cardiology, 1992-03, Vol.19 (3), p.619-629</ispartof><rights>1992 American College of Cardiology Foundation</rights><rights>1992 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-4261d36a4a1708c9f5b8fb6505ae41a356f26424b8e62995776d401c39127f3b3</citedby><cites>FETCH-LOGICAL-c404t-4261d36a4a1708c9f5b8fb6505ae41a356f26424b8e62995776d401c39127f3b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0735-1097(10)80282-7$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5213930$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1538019$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Colan, Steven D.</creatorcontrib><creatorcontrib>Parness, Ira A.</creatorcontrib><creatorcontrib>Spevak, Philip J.</creatorcontrib><creatorcontrib>Sanders, Stephen P.</creatorcontrib><title>Developmental modulation of myocardial mechanics: Age- and growth-related alterations in afterload and contractility</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Somatic growth is associated with alterations in myocardial mechanics in children with heart disease and in most animal models of congenital heart disease. However, the effect of age and body size on myocardial contractility and loading conditions in normal infants and children is not known. Therefore, 256 normal children aged 7 days to 19 years (34% <3 years old) were evaluated with noninvasive indexes of left ventricular contractility and loading conditions. Two-dimensional and M-mode echocardiographic recordings of the left ventricle were obtained with a phonocardiogram, indirect pulse tracing and blood pressure recordings. Left ventricular dimensions, wall thickness and pressure measurements obtained from these data were used to calculate peak and end-systolic circumferential and meridional wall stress and mean and integrated meridional wall stress. Velocity of shortening adjusted for heart rate was compared with end-systolic stress to assess contractility independently of loading status. The subjects were stratified for gender and each of the derived variables was related to age and body surface area.
Ventricular shape, assessed as the major/minor axis ratio, and the circumferential/meridional stress ratio were found to be invariant with growth. The ratio of posterior wall thickness to minor axis dimension did not change with age, despite the normal age-related increase in blood pressure. The increase in pressure despite unvarying ventricular shape and wall thickness/dimension ratio resulted in a substantial increase in wall stress that was most dramatic during the first few years of life. In association with the increase in afterload, systolic function decreased with age. However, the age-related decrease in the velocity of shortening was greater than that expected from the increase in afterload alone, indicating a higher level of contractility in infants and children during the first years of life than in older subjects.
The process of normal growth and development, similar to that in children with heart disease, is associated with a rapid decrease in the trophic response to hemodynamic loads, resulting in an age-associated increase in wall stress. There is a similar but somewhat more rapid decrease in contractility, with the highest values seen in the youngest patients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aging - physiology</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure - physiology</subject><subject>Cardiovascular system</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Heart - growth & development</subject><subject>Heart - physiology</subject><subject>Heart Ventricles - anatomy & histology</subject><subject>Humans</subject><subject>Infant</subject><subject>Investigative techniques of hemodynamics</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Myocardial Contraction - physiology</subject><subject>Stress, Mechanical</subject><subject>Stroke Volume - physiology</subject><subject>Ventricular Function, Left - physiology</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1v1DAQhi0EKkvhJ1TKASE4BDxxbCdcqqp8tFIlDsDZmtiT1siJF9tbtP--2Q-VY0_W-H3esfUwdgb8I3BQn35yLWQNvNfvgX_oeNM1tX7GViBlVwvZ6-ds9Yi8ZK9y_sM5Vx30J-wEpOg49CtWvtA9hbieaC4Yqim6TcDi41zFsZq20WJyfheQvcPZ2_y5urilusLZVbcp_it3daKlQa7CUCjtu7nyc4XjMoaIbs_aOJeEtvjgy_Y1ezFiyPTmeJ6y39--_rq8qm9-fL--vLipbcvbUreNAicUtgiad7Yf5dCNg5JcIrWAQqqxUW3TDh2ppu-l1sq1HKzoodGjGMQpe3fYu07x74ZyMZPPlkLAmeImG910oEDDAsoDaFPMOdFo1slPmLYGuNnZNnvbZqdyd7W3bfTSOzs-sBkmcv9bB71L_vaYY7YYxoSz9fkRkw2IXvAFOz9gtMi495RMtp5mS84nssW46J_4yAOu2Zx5</recordid><startdate>19920301</startdate><enddate>19920301</enddate><creator>Colan, Steven D.</creator><creator>Parness, Ira A.</creator><creator>Spevak, Philip J.</creator><creator>Sanders, Stephen P.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19920301</creationdate><title>Developmental modulation of myocardial mechanics: Age- and growth-related alterations in afterload and contractility</title><author>Colan, Steven D. ; Parness, Ira A. ; Spevak, Philip J. ; Sanders, Stephen P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-4261d36a4a1708c9f5b8fb6505ae41a356f26424b8e62995776d401c39127f3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aging - physiology</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure - physiology</topic><topic>Cardiovascular system</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Heart - growth & development</topic><topic>Heart - physiology</topic><topic>Heart Ventricles - anatomy & histology</topic><topic>Humans</topic><topic>Infant</topic><topic>Investigative techniques of hemodynamics</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Myocardial Contraction - physiology</topic><topic>Stress, Mechanical</topic><topic>Stroke Volume - physiology</topic><topic>Ventricular Function, Left - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Colan, Steven D.</creatorcontrib><creatorcontrib>Parness, Ira A.</creatorcontrib><creatorcontrib>Spevak, Philip J.</creatorcontrib><creatorcontrib>Sanders, Stephen P.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Colan, Steven D.</au><au>Parness, Ira A.</au><au>Spevak, Philip J.</au><au>Sanders, Stephen P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Developmental modulation of myocardial mechanics: Age- and growth-related alterations in afterload and contractility</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1992-03-01</date><risdate>1992</risdate><volume>19</volume><issue>3</issue><spage>619</spage><epage>629</epage><pages>619-629</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Somatic growth is associated with alterations in myocardial mechanics in children with heart disease and in most animal models of congenital heart disease. However, the effect of age and body size on myocardial contractility and loading conditions in normal infants and children is not known. Therefore, 256 normal children aged 7 days to 19 years (34% <3 years old) were evaluated with noninvasive indexes of left ventricular contractility and loading conditions. Two-dimensional and M-mode echocardiographic recordings of the left ventricle were obtained with a phonocardiogram, indirect pulse tracing and blood pressure recordings. Left ventricular dimensions, wall thickness and pressure measurements obtained from these data were used to calculate peak and end-systolic circumferential and meridional wall stress and mean and integrated meridional wall stress. Velocity of shortening adjusted for heart rate was compared with end-systolic stress to assess contractility independently of loading status. The subjects were stratified for gender and each of the derived variables was related to age and body surface area.
Ventricular shape, assessed as the major/minor axis ratio, and the circumferential/meridional stress ratio were found to be invariant with growth. The ratio of posterior wall thickness to minor axis dimension did not change with age, despite the normal age-related increase in blood pressure. The increase in pressure despite unvarying ventricular shape and wall thickness/dimension ratio resulted in a substantial increase in wall stress that was most dramatic during the first few years of life. In association with the increase in afterload, systolic function decreased with age. However, the age-related decrease in the velocity of shortening was greater than that expected from the increase in afterload alone, indicating a higher level of contractility in infants and children during the first years of life than in older subjects.
The process of normal growth and development, similar to that in children with heart disease, is associated with a rapid decrease in the trophic response to hemodynamic loads, resulting in an age-associated increase in wall stress. There is a similar but somewhat more rapid decrease in contractility, with the highest values seen in the youngest patients.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>1538019</pmid><doi>10.1016/S0735-1097(10)80282-7</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aging - physiology Biological and medical sciences Blood Pressure - physiology Cardiovascular system Child Child, Preschool Echocardiography Female Heart - growth & development Heart - physiology Heart Ventricles - anatomy & histology Humans Infant Investigative techniques of hemodynamics Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Myocardial Contraction - physiology Stress, Mechanical Stroke Volume - physiology Ventricular Function, Left - physiology |
| title | Developmental modulation of myocardial mechanics: Age- and growth-related alterations in afterload and contractility |
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