Ergometric studies of untrained skeletal muscle demonstrate feasibility of muscle-powered cardiac assistance.

The feasibility of biomechanical circulatory assistance hinges on the capacity of skeletal muscle to generate significant hemodynamic work. This study quantifies linear contractile energetics via a customized hydraulic ergometer. Six normal canine latissimus dorsi (LD) muscles (200 +/- 25 g) were evaluated. The muscles were not mobilized; thereby their collateral circulation was preserved. The humeral insertion of the LD muscle was transected and connected to the ergometer. Preload was adjusted to return the LD muscle to its in situ length, and one pulse train was delivered every second. The resulting contractions generated peak pressures of 134 +/- 17 mmHg with mean pressures during shortening of 102 +/- 12 mmHg. Flow rates averaged 5.45 +/- 0.26 l/min. Mechanical work output was calculated at 1.14 +/- 0.18 J/contraction, yielding an average power production of 4.57 +/- 0.72 W during shortening. Continuous LD output power, measured at 5.76 +/- 0.90 mW/g, compares favorably with the 3.48 mW/g typically generated by a 350-g human heart. We therefore conclude that skeletal muscle of sufficient mass can sustain work rates suitable for cardiac assistance despite the 50% power losses typically experienced after muscle training.