Abstract
We have recently proposed that the total mechanical energy generated in each cardiac contraction can be quantified by the systolic pressure-volume area (PVA). PVA is the area in the pressure-volume (P-V) diagram that is circumscribed by the end-systolic and end-diastolic P-V relation curves and the systolic segment of the P-V trajectory. This area has dimensions of energy and comprises the external mechanical work and the elastic potential energy. In the left ventricle of cross-circulated canine hearts, we studied the relation between PVA and oxygen consumption per beat (Vo2) above Vo2for mechanically unloaded contraction. We assumed that this excess Vo2is utilized for mechanical contraction by the contractile machinery. The percentage of PVA in the excess Vo2, both in the same unit of energy, J, would then represent the efficiency of energy conversion from the excess Vo2to the total mechanical energyin the contractile machinery. We obtained this efficiency in variously loaded contractions in both control and enhanced contractile states with epinephrine and calcium. We found that the efficiency was constant at 30-50 (mean 40) % regardless of the changes in both loading conditions and contractile states. By this constant efficiency and a variable fraction of external work in PVA, we accounted for the load- and contractility-dependent variability of the conventional mechanical efficiency (0-30%) of the heart.
