Performance of dynamic and isovolumetric trained skeletal muscle ventricles.

BACKGROUND: Dynamic training and maintaining muscle tension are important factors during skeletal muscle ventricle (SMV) conditioning that may improve SMV performance. This study sought to determine the effects of dynamic muscle training and progressive SMV resting pressure expansion on SMV pumping capability. MATERIALS AND METHODS: SMVs were constructed in 14 goats using the left latissimus dorsi muscle. SMVs were conditioned with a 40 ml constant-volume isovolumetric implant (n = 5, IsoVol group) or a compliant, pneumatic system that allowed dynamic shortening and direct exposure to resting pressures. Dynamic SMV resting pressure was either progressively increased from 40 to 100 to 120 mmHg (n = 5, HiP group) or maintained at 40 mmHg (n = 4, LowP group) during conditioning. After 8 to 10 weeks of electrical stimulation conditioning, SMVs were connected to a counterpulsation mock circulation system and SMV pumping performance evaluated across a range of pressures and stimulation parameters. RESULTS: SMV pumping performance was similar in each group. Stroke works generally increased with pressure and reached a plateau in all groups above 80 mmHg (120 msec contraction approximately 80 mJ/stroke; 480 msec contraction approximately 180 mJ/stroke). Stroke volumes decreased with pressure except at high stimulation levels where loading effects were observed. Chronic changes in SMV volume significantly effected pumping performance. CONCLUSIONS: These data suggest that acute pumping performance is not different between 8 to 10 weeks of dynamic or isovolumetric training if SMV volume is not constrained. A potentially improved SMV conditioning protocol is proposed that determines, positions, and maintains SMV volume near the initial volume for maximal isovolumetric pressure during conditioning.

Is skeletal muscle ventricle chronic stability dependent on wall stress? Design implications.

Chronic skeletal muscle ventricle (SMV) stability is essential for clinical implementation. SMVs in animal models have chronically expanded or collapsed when exposed to physiologic pressures. SMV wall stress is a more appropriate indicator than pressure or geometry to compare SMVs between studies. SMV wall tensions during conditioning were determined for SMVs that collapsed, expanded, or were isovolumetric in a previous study. Wall stresses in SMVs that expanded (2.76 +/- 0.803 N/cm(2)) were significantly greater than isovolumetric SMVs (0.89 +/- 0.450) and SMVs that collapsed (0.88 +/- 0.451). These data support the existence of minimum and maximum wall stresses for SMV volume stability and provide empiric estimates for SMV design. Scaling SMV designs from animal models with smaller volumes and similar pressures may result in greater wall stresses in clinical designs. Therefore, the use of volume limiting implants or an isovolumetric conditioning phase to increase the wall stress expansion threshold may be required.

Skeletal muscle ventricle pressure-volume properties conform to dynamic and static conditioning.

BACKGROUND: Chronic changes in skeletal muscle ventricle (SMV) size and strength can directly affect performance and stability. These changes may depend on the conditioning protocol or implant system. Therefore the effects of conditioning protocols on SMV geometry and contractility must be identified for optimal SMV design and application. METHODS: Skeletal muscle ventricles were constructed in 14 goats using the left latissimus dorsi muscle. The SMVs were conditioned with a 40 mL constant-volume isovolumetric implant (n = 5, IsoVol group) or a compliant pneumatic system that allowed dynamic shortening and direct exposure to resting pressures. Dynamic SMV resting pressure was either progressively increased from 40 to 100 to 120 mm Hg (n = 5, high pressure [HiP] group) or maintained at 40 mm Hg (n = 4, low pressure [LowP] group) during conditioning. The SMV pressure and volume characteristics were monitored daily. RESULTS: All HiP SMVs expanded in volume during conditioning after exposure to physiologic pressures. Three of 4 LowP SMVs decreased in volume during conditioning. Skeletal muscle ventricle passive and active (isovolumetric evoked pressure) pressure-volume curves shifted toward the increasing, stable, and decreasing volumes in HiP, IsoVol, and LowP SMVs respectively. CONCLUSIONS: Frequent monitoring of SMV characteristics during conditioning enabled progressive pressure training and is a valuable tool to evaluate SMV conformation. Chronic SMV adaptation is dependent on the conditioning protocol or implant system utilized. Demonstration of SMV expansion at physiologic pressures suggests that clinical sized SMVs may be chronically unstable unless a supporting implant system is utilized or SMV compliance is reduced. Therefore the mechanisms effecting chronic expansion should be further defined to optimally design SMVs for clinical implementation.