Measuring the mechanical efficiency of a working cardiac muscle sample at body temperature using a flow-through calorimeter

Crossbridge thermodynamics in pulmonary arterial hypertensive right-ventricular failure

Right-ventricular (RV) failure is an event consequent to pathological RV hypertrophy commonly resulting from pulmonary arterial hypertension. This pathology is well characterized by RV diastolic dysfunction, impaired ejection, and reduced mechanical efficiency. However, whether the dynamic stiffness and cross-bridge thermodynamics in the failing RV muscles are compromised remains uncertain. Pulmonary arterial hypertension was induced in the rat by injection of monocrotaline, and RV trabeculae were isolated from RV failing rats. Cross-bridge mechano-energetics were characterized by subjecting the trabeculae to two interventions: 1) force-length work-loop contractions over a range of afterloads while measuring heat output, followed by careful partitioning of heat components into activation heat and cross-bridge heat to separately assess mechanical efficiency and cross-bridge efficiency, and 2) sinusoidal-perturbation of muscle length while trabeculae were actively contracting to interrogate cross-bridge dynamic stiffness. We found that reduced mechanical efficiency is correlated with increased passive stress, reduced shortening, and elevated activation heat. In contrast, the thermodynamics, specifically the efficiency of, and the stiffness characteristics of, cross bridges did not differ between the control and failing trabeculae and were not correlated with elevated passive stress or reduced shortening. We thus conclude that, despite diastolic dysfunction and mechanical inefficiency, cross-bridge stiffness and thermodynamics are unaffected in RV failure following pulmonary arterial hypertension.

NEW & NOTEWORTHY This study characterizes cross-bridge mechano-energetics and dynamic stiffness of right-ventricular trabeculae isolated from a rat model of pulmonary hypertensive right-ventricular failure. Failing trabeculae showed increased passive force but normal active force. Their lower mechanical efficiency is found to be driven by an increase in the energy expenditure arising from contractile activation. This does not reflect a change in their cross-bridge stiffness and efficiency.

Compensating for changes in heart muscle resting heat production in a microcalorimeter

The heat production of cardiac muscle, determined by calorimetry, can be used as a measure of cardiac metabolism. However, heat produced while a muscle is actively-shortening, thereby performing force-length work, comprises both active and basal metabolic processes. In this paper, we present a method for post-experimental processing of calorimetric measurements of muscle heat production, that uncovers and compensates for the measured basal heat rate during work. In this method, the relationships between muscle length, velocity of length change and muscle heat output are coupled with a simulation of the measurement instrument, providing a model-based estimate of change of measured basal heat while the muscle is performing work. We demonstrate the use of this technique in an experiment conducted on a working cardiac muscle sample. The ability to identify the various components of heat release in these muscles provides useful insight into their mechanical and energetic capabilities.

Mechanical loading of isolated cardiac muscle with a real-time computed Windkessel model of the vasculature impedance

To date, the mechanical loads imposed on isolated cardiac muscle tissue in vitro have been oversimplified. Researchers typically applied loads that are time-invariant, resulting in either isometric and auxotonic contractions, or flat-topped (isotonic shortening) work-loops. These contraction types do not fully capture the dynamic response of contracting tissues adapting to a variable load, such as is experienced by ventricular tissue in vivo. In this study, we have successfully developed a loading system that presents a model-based, time-varying, continuously updated, load to cardiac tissue preparations. We combined a Windkessel model of vascular fluid impedance together with Laplace's Law and encoded it in a real-time hardware-based force-length control system. Experiments were carried out on isolated rat left ventricular trabeculae; we directly compare the work-loops arising from this protocol with those of a typical simplified isotonic shortening work-loop system. We found that, under body conditions, cardiac trabeculae achieved greater mechanical work output against our new loading system, than with the simplified isotonic work-loop protocol. We further tested whether loading the tissue with a mechanical impedance defined by "diseased" Windkessel model parameters had an effect on the performance of healthy trabeculae. We found that trabecula shortening decreased when applying the set of Windkessel parameters describing the hypertensive condition, and increased in the hypotensive state. Our implementation of a real-time model of arterial characteristics provides an improved, physiologically derived, instantly calculated load for use in studying isolated cardiac muscle, and is readily applicable to study various disease conditions.

Energy expenditure for isometric contractions of right and left ventricular trabeculae over a wide range of frequencies at body temperature

We studied the energy expenditure of isometric contractions using both right-ventricular (RV) and left-ventricular (LV) trabeculae isolated from the rat heart. The energy expenditure under isometric contraction presents entirely as heat liberation. Preparations were challenged to perform at various rates of energy demand while accounting for their inevitable time-dependent decline of performance. They were electrically stimulated to contract at 37 °C with a frequency order (between 0.1 Hz and 10 Hz) dictated by a fully-balanced Latin-Square experimental design. We measured, simultaneously, their stress production and heat output. As functions of stimulus frequency, active stress and heat were not significantly different between RV and LV trabeculae. However, contraction kinetics, indexed as the maximal rate of rise and fall of twitch, were lower in the LV trabeculae. The ratio of heat to stress was greater in the LV trabeculae, suggesting that the economy of contraction of the LV trabeculae is lower. Their lower economy became more pronounced at high stimulus frequencies. Our results allow us to assess whether slowing of kinetics is a causative mechanism for improvement of economy of contraction.

Solving a century-old conundrum underlying cardiac force-length relations

In the late 19th century, Otto Frank presented a diagram (Frank O. Z Biol 37: 483-526, 1899) showing that cardiac end-systolic pressure-volume relations are dependent on the mode of contraction: one for isovolumic contractions that locate above that for afterloaded ejecting contractions. Conflicting results to Frank's have been subsequently demonstrated in various species, both within and among preparations, ranging from the whole hearts to single myocytes, showing a single pressure-volume or force-length relation that is independent of the mode of contraction. Numerous explanations for these conflicting results have been proposed but are mutually contradictory and hence unsatisfying. The present study aimed to explore how these conflicting findings can be reconciled. We thus explored the cardiac force-length relation across a wide spectrum of both preloads and afterloads, encompassing the physiological working range. Experiments were performed using isolated ventricular trabeculae at physiological temperature and stimulus frequency. The force-length relation obtained from isometric contractions was indeed located above a family of those obtained from shortening contractions. Low preload conditions rendered the relation contraction mode independent. High afterload conditions also showed a comparable effect. Our exploration allowed us to reveal the loading conditions that can explain the apparent single, contraction mode-independent, force-length relation that is in contrast with that presented by Frank. Resolving this century-old cardiac conundrum highlights the caution that must be taken when using the end-systolic force-length relation to illustrate as well as to understand the concepts of the Frank-Starling law of the heart, "potential energy," and cardiac contractility. NEW & NOTEWORTHY Our exploration of the cardiac force-length relation under wide ranges of preload and afterload has allowed us to reconcile conflicting results in the literature regarding its length dependency. We show that the relation is dependent on the mode of contraction but can appear to be otherwise under certain conditions. This finding highlights the need for caution when using the force-length relation to understand key concepts in cardiac physiology.

Pulmonary arterial hypertension reduces energy efficiency of right, but not left, rat ventricular trabeculae

KEY POINTS

Pulmonary arterial hypertension (PAH) triggers right ventricle (RV) hypertrophy and left ventricle (LV) atrophy, which progressively leads to heart failure. We designed experiments under conditions mimicking those encountered by the heart in vivo that allowed us to investigate whether consequent structural and functional remodelling of the ventricles affects their respective energy efficiencies. We found that peak work output was lower in RV trabeculae from PAH rats due to reduced extent and velocity of shortening. However, their suprabasal enthalpy was unaffected due to increased activation heat, resulting in reduced suprabasal efficiency. There was no effect of PAH on LV suprabasal efficiency. We conclude that the mechanism underlying the reduced energy efficiency of hypertrophied RV tissues is attributable to the increased energy cost of Ca²⁺ cycling, whereas atrophied LV tissues still maintain normal mechano-energetic performance.

ABSTRACT

Pulmonary arterial hypertension (PAH) greatly increases the afterload on the right ventricle (RV), triggering RV hypertrophy, which progressively leads to RV failure. In contrast, the disease reduces the passive filling pressure of the left ventricle (LV), resulting in LV atrophy. We investigated whether these distinct structural and functional consequences to the ventricles affect their respective energy efficiencies. We studied trabeculae isolated from both ventricles of Wistar rats with monocrotaline-induced PAH and their respective Control groups. Trabeculae were mounted in a calorimeter at 37°C. While contracting at 5 Hz, they were subjected to stress-length work-loops over a wide range of afterloads. They were subsequently required to undergo a series of isometric contractions at various muscle lengths. In both protocols, stress production, length change and suprabasal heat output were simultaneously measured. We found that RV trabeculae from PAH rats generated higher activation heat, but developed normal active stress. Their peak external work output was lower due to reduced extent and velocity of shortening. Despite lower peak work output, suprabasal enthalpy was unaffected, thereby rendering suprabasal efficiency lower. Crossbridge efficiency, however, was unaffected. In contrast, LV trabeculae from PAH rats maintained normal mechano-energetic performance. Pulmonary arterial hypertension reduces the suprabasal energy efficiency of hypertrophied right ventricular tissues as a consequence of the increased energy cost of Ca²⁺ cycling.

Left-Ventricular Energetics in Pulmonary Arterial Hypertension-Induced Right-Ventricular Hypertrophic Failure

Pulmonary arterial hypertension (PAH) alters the geometries of both ventricles of the heart. While the right ventricle (RV) hypertrophies, the left ventricle (LV) atrophies. Multiple lines of clinical and experimental evidence lead us to hypothesize that the impaired stroke volume and systolic pressure of the LV are a direct consequence of the effect of pressure overload in the RV, and that atrophy in the LV plays only a minor role. In this study, we tested this hypothesis by examining the mechanoenergetic response of the atrophied LV to RV hypertrophy in rats treated with monocrotaline. Experiments were performed across multiple-scales: the whole-heart in vivo and ex vivo, and its trabeculae in vitro. Under the in vivo state where the RV was pressure-overloaded, we measured reduced systemic blood pressure and LV ventricular pressure. In contrast, under both ex vivo and in vitro conditions, where the effect of RV pressure overload was circumvented, we found that LV was capable of developing normal systolic pressure and stress. Nevertheless, LV atrophy played a minor role in that LV stroke volume remained lower, thereby contributing to lower LV mechanical work output. Concomitantly lower oxygen consumption and change of enthalpy were observed, and hence LV energy efficiency was unchanged. Our internally consistent findings between working-heart and trabecula experiments explain the rapid improvement of LV systolic function observed in patients with chronic pulmonary hypertension following surgical relief of RV pressure overload.

Do right-ventricular trabeculae gain energetic advantage from having a greater velocity of shortening?

KEY POINTS

We designed a study to test whether velocity of shortening in right-ventricular tissue preparations is greater than that of the left side under conditions mimicking those encountered by the heart in vivo. Our experiments allowed us to explore whether greater velocity of shortening results in any energetic advantage. We found that velocity of shortening was higher in the rat right-ventricular trabeculae. These results at the tissue level seem paradoxical to the velocity of ventricular ejection at the organ level, and are not always in accord with shortening of unloaded cells. Despite greater velocity of shortening in right-ventricular trabeculae, they neither gained nor lost advantage with respect to both mechanical efficiency and the heat generated during shortening.

ABSTRACT

Our study aimed to ascertain whether the interventricular difference of shortening velocity, reported for isolated cardiac tissues in vitro, affects interventricular mechano-energetic performance when tested under physiological conditions using a shortening protocol designed to mimic those in vivo. We isolated trabeculae from both ventricles of the rat, mounted them in a calorimeter, and performed experiments at 37°C and 5 Hz stimulus frequency to emulate conditions of the rat heart in vivo. Each trabecula was subjected to two experimental protocols: (i) isotonic work-loop contractions at a variety of afterloads, and (ii) isometric contractions at a variety of preloads. Velocity of shortening was calculated from the former protocol during the isotonic shortening phase of the contraction. Simultaneous measurements of force-length work and heat output allowed calculation of mechanical efficiency. The shortening-dependent thermal component was quantified from the difference in heat output between the two protocols. Our results show that both extent of shortening and velocity of shortening were higher in trabeculae from the right ventricle. Despite these differences, trabeculae from both ventricles developed the same stress, performed the same work, liberated the same amount of heat, and hence operated at the same mechanical efficiency. Shortening heat was also ventricle independent. The interventricular differences in velocity of shortening and extent of shortening of isolated trabeculae were not manifested in any index of energetics. These collective results underscore the absence of any mechano-energetic advantage or disadvantage conferred on right-ventricular trabeculae arising from their superior velocity of shortening.

Experimental and modelling evidence of shortening heat in cardiac muscle

KEY POINTS

Heat associated with muscle shortening has been repeatedly demonstrated in skeletal muscle, but its existence in cardiac muscle remains contentious after five decades of study. By iterating between experiments and computational modelling, we show compelling evidence for the existence of shortening heat in cardiac muscle and reveal, mechanistically, the source of this excess heat. Our results clarify a long-standing uncertainty in the field of cardiac muscle energetics. We provide a revised partitioning of cardiac muscle energy expenditure to include this newly revealed thermal component.

ABSTRACT

When a muscle shortens against an afterload, the heat that it liberates is greater than that produced by the same muscle contracting isometrically at the same level of force. This excess heat is defined as 'shortening heat', and has been repeatedly demonstrated in skeletal muscle but not in cardiac muscle. Given the micro-structural similarities between these two muscle types, and since we imagine that shortening heat is the thermal accompaniment of cross-bridge cycling, we have re-examined this issue. Using our flow-through microcalorimeter, we measured force and heat generated by isolated rat trabeculae undergoing isometric contractions at different muscle lengths and work-loop (shortening) contractions at different afterloads. We simulated these experimental protocols using a thermodynamically constrained model of cross-bridge cycling and probed the mechanisms underpinning shortening heat. Predictions generated by the model were subsequently validated by a further set of experiments. Both our experimental and modelling results show convincing evidence for the existence of shortening heat in cardiac muscle. Its magnitude is inversely related to the afterload or, equivalently, directly related to the extent of shortening. Computational simulations reveal that the heat of shortening arises from the cycling of cross-bridges, and that the rate of ATP hydrolysis is more sensitive to change of muscle length than to change of afterload. Our results clarify a long-standing uncertainty in the field of cardiac muscle energetics.

Real-time model-based control of afterload for in vitro cardiac tissue experimentation

The performance of mechanical work by isolated cardiac muscle samples has typically been studied by subjecting their tissues to an isotonic shortening protocol, which results in "flat-topped" work-loop profiles. In order to better replicate the forces experienced by these tissues in vivo, we have developed a system for imposing a model-based, time-varying, load on isolated cardiac tissue preparations. A model of systemic afterload was developed from the combination of a Windkessel-type model of vascular fluid impedance, and the Laplace law of the heart, and encoded into a hardware-based control system. The model-predicted length change was then imposed on an isolated cardiac trabecula in a work-loop calorimeter, giving rise to force-length work-loops that more closely resemble those experienced by these tissues in vivo.

Does the intercept of the heat-stress relation provide an accurate estimate of cardiac activation heat?

KEY POINTS

The heat of activation of cardiac muscle reflects the metabolic cost of restoring ionic homeostasis following a contraction. The accuracy of its measurement depends critically on the abolition of crossbridge cycling. We abolished crossbridge activity in isolated rat ventricular trabeculae by use of blebbistatin, an agent that selectively inhibits myosin II ATPase. We found cardiac activation heat to be muscle length independent and to account for 15-20% of total heat production at body temperature. We conclude that it can be accurately estimated at minimal muscle length.

ABSTRACT

Activation heat arises from two sources during the contraction of striated muscle. It reflects the metabolic expenditure associated with Ca²⁺ pumping by the sarcoplasmic reticular Ca²⁺ -ATPase and Ca²⁺ translocation by the Na⁺ /Ca²⁺ exchanger coupled to the Na⁺ ,K⁺ -ATPase. In cardiac preparations, investigators are constrained in estimating its magnitude by reducing muscle length to the point where macroscopic twitch force vanishes. But this experimental protocol has been criticised since, at zero force, the observed heat may be contaminated by residual crossbridge cycling activity. To eliminate this concern, the putative thermal contribution from crossbridge cycling activity must be abolished, at least at minimal muscle length. We achieved this using blebbistatin, a selective inhibitor of myosin II ATPase. Using a microcalorimeter, we measured the force production and heat output, as functions of muscle length, of isolated rat trabeculae from both ventricles contracting isometrically at 5 Hz and at 37°C. In the presence of blebbistatin (15 μmol l^-1 ), active force was zero but heat output remained constant, at all muscle lengths. Activation heat measured in the presence of blebbistatin was not different from that estimated from the intercept of the heat-stress relation in its absence. We thus reached two conclusions. First, activation heat is independent of muscle length. Second, residual crossbridge heat is negligible at zero active force; hence, the intercept of the cardiac heat-force relation provides an estimate of activation heat uncontaminated by crossbridge cycling. Both results resolve long-standing disputes in the literature.

Cardiac muscle energetics: Improved normalisation of heat using optical coherence tomography

Heat liberated from isolated cardiac muscle has been used to inform us of thermo-mechanical processes that occur during a contraction. However, for comparisons between different samples to be useful, the heat output needs to be normalized to volume. We have implemented an optical coherence tomograph (OCT), together with a flow-through calorimeter, to accurately determine both muscle volume and heat in the same measurement chamber. The heat rate for multiple stimulation frequencies were recorded and normalized to the volume captured by the OCT. There was a ~15 % difference in the volume estimated by the OCT compared to the standard 1D approximation, suggesting the need for this imaging system, especially for irregularly shaped muscles.

Four-Dimensional Imaging of Cardiac Trabeculae Contracting In Vitro Using Gated OCT

Cardiac trabeculae are widely used as experimental muscle preparations for studying heart muscle. However, their geometry (diameter, length, and shape) can vary not only among samples, but also within a sample, leading to inaccuracies in estimating their stress production, volumetric energy output, and/or oxygen consumption. Hence, it is desirable to have a system that can accurately image each trabecula in vitro during an experiment. To this end, we constructed an optical coherence tomography system and implemented a gated imaging procedure to image actively contracting trabeculae and reconstruct their time-varying geometry. By imaging a single cross section while monitoring the developed force, we found that gated stimulation of the muscle was sufficiently repeatable to allow us to reconstruct multiple contractions to form a four-dimensional representation of a single muscle contraction cycle. The complete muscle was imaged at various lengths and the cross-sectional area along the muscle was quantified during the contraction cycle. The variation of cross-sectional area along the length during a contraction tended to increase as the muscle was contracting, and this increase was greater at longer muscle lengths. To our knowledge, this is the first system that is able to measure the geometric change of cardiac trabeculae in vitro during a contraction, allowing cross-sectional stress and other volume-dependent parameters to be estimated with greater accuracy.

Muscle heat: a window into the thermodynamics of a molecular machine

The contraction of muscle is characterized by the development of force and movement (mechanics) together with the generation of heat (metabolism). Heat represents that component of the enthalpy of ATP hydrolysis that is not captured by the microscopic machinery of the cell for the performance of work. It arises from two conceptually and temporally distinct sources: initial metabolism and recovery metabolism. Initial metabolism comprises the hydrolysis of ATP and its rapid regeneration by hydrolysis of phosphocreatine (PCr) in the processes underlying excitation-contraction coupling and subsequent cross-bridge cycling and sliding of the contractile filaments. Recovery metabolism describes those process, both aerobic (mitochondrial) and anaerobic (cytoplasmic), that produce ATP, thereby allowing the regeneration of PCr from its hydrolysis products. An equivalent partitioning of muscle heat production is often invoked by muscle physiologists. In this formulation, total enthalpy expenditure is separated into external mechanical work (W) and heat (Q). Heat is again partitioned into three conceptually distinct components: basal, activation, and force dependent. In the following mini-review, we trace the development of these ideas in parallel with the development of measurement techniques for separating the various thermal components.