Circulation, Vol 70, 1057-1065, Copyright © 1984 by American Heart Association
A Kono, WL Maughan, K Sunagawa, K Hamilton, K Sagawa and ML Weisfeldt
The end-systolic pressure-volume relationship (ESPVR) as derived from left
ventricular pressure-volume loops has gained increasing acceptance as an
index of ventricular contractile function. In animal experiments the ESPVR
has been defined as a line connecting the upper left corners of several
differently loaded pressure-volume (P-V) loops with a slope parameter Ees
and a volume axis intercept parameter Vo. In the clinical setting, several
variants of the ESPVR have been determined with use of peak left
ventricular pressure, end-ejection pressure, and end-ejection volume. The
maximum P-V ratio has also frequently been measured. We attempted to
determine which of these alternatives resulted in good approximations of
the reference ESPVR in eight isolated canine ventricles that ejected into a
simulated arterial impedance system with resistance, compliance, and
characteristic impedance. We determined various versions of the ESPVR from
the same set of beats quickly obtained with little change in inotropic
background. To vary ventricular pressure wave forms, each of the arterial
impedance parameters was independently controlled at 50%, 100%, and 200% of
normal. Against each of the nine combinations of the impedance parameters
four P-V loops were obtained under four preloads and from each of the sets
of four P-V loops, the reference ESPVR, linear regression of the peak
pressure on end-ejection volume (ESPVRPP-EEV), and linear regression of
end-ejection pressure on end-ejection volume (ESPVREEPV) were determined.
In addition, the maximum P-V ratio (MPVR) was calculated for each P-V
loop.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
The use of left ventricular end-ejection pressure and peak pressure in the estimation of the end-systolic pressure-volume relationship
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