Epicardial deformation and left ventricular wall mechanisms during ejection in the dog.

Significant differences between epicardial and endocardial systolic stress in the wall of the left ventricle (LV) have been predicted by various models of LV mechanics. Yet a model incorporating transmural differences in fiber orientation and torsion, defined as a rotation of the apex with respect to the base around the long axis of the LV, predicts transmural equalization of stress and shortening along the fiber direction during the ejection phase. this equalization is due to an interplay between torsion and myocardial contraction. To assess the model hypothesis, predicted epicardial deformation during the ejection phase was compared with that measured experimentally. For this purpose 45 sets of measurements were performed in four open-chest dogs using a triangular array of inductive gauges for the assessment of epicardial circumferential strain (epsilon c), base-to-apex strain (epsilon z), and shear angle (gamma). Changes in shear angle are directly related to LV torsion. LV end-diastolic pressure was varied over a wide range (0-15 mmHg) by volume loading and bleeding. In the control state, the slope of the shear angle vs. volume strain curve (volume strain = 2 epsilon c + epsilon z), which is related to contraction, was found to be 0.74 +/- 0.10 (mean +/- SD). This compares reasonably wih the mathematical model prediction of a slope of 0.67. Due to an interplay between torsion and contraction, left ventricular fiber stress and fiber shortening might be uniformly distributed across the wall.