Myocardial oxygen consumption, myocardial efficiency, and mechanical efficiency: A review across pathologic and physiologic states

TY - JOUR

T1 - Myocardial oxygen consumption, myocardial efficiency, and mechanical efficiency

T2 - A review across pathologic and physiologic states

AU - Pierson, Julia A.

AU - Mitrev, Ludmil

AU - Hill, Jeffrey C.

AU - Mulligan, Lawrence J.

N1 - Publisher Copyright: © 2026 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.

PY - 2026/5

Y1 - 2026/5

N2 - Myocardial work and oxygen consumption (MVO2) are tightly coupled. The patient's physiological state, presence of disease, heart rate, and microvascular control of oxygen delivery all combine to maintain this relationship. The myocardial efficiency (MyoEff) of the heart is determined by the ratio of stroke-work (SW) divided by MVO2, whereas mechanical efficiency (ME) is derived from the left ventricular pressure-volume loop construct and is the ratio of SW to pressure-volume area. The need to collect invasive data limited the ability to perform human studies, but the development of noninvasive tools such as positron emission tomography (PET) combined with echocardiography led to a resurgence in this field of study. We summarize the current understanding of the significance of MyoEff and ME as outcomes predictors after aortic valve replacement and as parameters in cardiovascular health, highlighting their potential for improving risk stratification and guiding prophylactic interventions.

AB - Myocardial work and oxygen consumption (MVO2) are tightly coupled. The patient's physiological state, presence of disease, heart rate, and microvascular control of oxygen delivery all combine to maintain this relationship. The myocardial efficiency (MyoEff) of the heart is determined by the ratio of stroke-work (SW) divided by MVO2, whereas mechanical efficiency (ME) is derived from the left ventricular pressure-volume loop construct and is the ratio of SW to pressure-volume area. The need to collect invasive data limited the ability to perform human studies, but the development of noninvasive tools such as positron emission tomography (PET) combined with echocardiography led to a resurgence in this field of study. We summarize the current understanding of the significance of MyoEff and ME as outcomes predictors after aortic valve replacement and as parameters in cardiovascular health, highlighting their potential for improving risk stratification and guiding prophylactic interventions.

UR - https://www.scopus.com/pages/publications/105039607707

UR - https://www.scopus.com/pages/publications/105039607707#tab=citedBy

U2 - 10.14814/phy2.70890

DO - 10.14814/phy2.70890

M3 - Review article

C2 - 42163800

SN - 2051-817X

VL - 14

JO - Physiological Reports

JF - Physiological Reports

IS - 10

M1 - e70890

ER -