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Responses of the Heart to Mechanical Stress

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Biomechanics

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Summary

Adaptation of the heart to mechanical load is seen during normal development. A harmonized coordination between structure and function is observed on the integration of right and left ventricles as a low-pressure and a high-pressure pump, respectively. Both ventricles eject the same amount of blood to their respective peripheral circulation, but differ in intracavitary pressure, wall thickness, and shape. When coronary perfusion pressure is decreased below the level (critical pressure) of coronary flow autoregulation, regional wall motion deteriorates. The level of critical pressure is determined by the level of afterload, and is lower in the right than in the left coronary artery. The spatial distribution of the infarcted area following coronary branch ligation was quite different between the right and left ventricles, which is largely explained by the different level of inherent mechanical load between the respective ventricles. Abnormalities of mechanical load in mature heart also alter the structure and function not only of the vascular system but also of the four chambers of the heart. Although hypertrophic changes of the heart as a consequence of adaptation to mechanical overload are beneficial at the early phase for mitigating hemodynamic burdens noted in the diseased heart, chronic overload results in maladaptation or remodeling. In inevitable sequelae, changes in structure do not provide amelioration of cardiac pump performance, ultimately resulting in death. Recent clinical trials have provided clues to long-term structural improvement in the heart as a bonus of the reduced ventricular preload and afterload. These beneficial effects improve prognosis in heart failure. Altered gene expression and phenotypic alteration have drawn attention as being causative of hypertrophy and remodeling.

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Author information

Authors and Affiliations

  1. The First Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata, 990-23, Japan

    Hitonobu Tomoike

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  1. Hitonobu Tomoike
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Editors and Affiliations

  1. Department of Mechanical Engineering, Faculty of Engineering Science, Osaka University, 1-3 Machikaneyama-cho, Toyonaka, Osaka, 560, Japan

    Kozaburo Hayashi Ph.D.

  2. Institute of Medical Electronics, University of Tokyo School of Medicine, 7-3-1 Hongo ,Bunkyo-ku, Tokyo, 113, Japan

    Akira Kamiya M.D., Ph.D.

  3. Osaka Koseinenkin Hospital, 4-2-78 Fukushima ,Fukushima-ku, Osaka, 553, Japan

    Keiro Ono M.D., Ph.D.

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© 1996 Springer-Verlag Tokyo

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Tomoike, H. (1996). Responses of the Heart to Mechanical Stress. In: Hayashi, K., Kamiya, A., Ono, K. (eds) Biomechanics. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68317-9_3

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  • DOI: https://doi.org/10.1007/978-4-431-68317-9_3

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68319-3

  • Online ISBN: 978-4-431-68317-9

  • eBook Packages: Springer Book Archive

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