Circulation, Vol 74, 1107-1113, Copyright © 1986 by American Heart Association
GL Freeman, WC Little and RA O'Rourke
The left ventricular end-systolic pressure-volume relation has received
intense interest as a relatively load-insensitive measure of cardiac
performance. In clinical studies, pharmacologic manipulation of blood
pressure has been used to determine this relation. Since previous studies
have shown that acute changes in the resistance and impedance of the
arterial circulation influence the left ventricular end-systolic
pressure-volume relation, the use of vasoactive drugs in its determination
may affect the results achieved. This study was undertaken to determine
whether clinically used vasoactive drugs influence the left ventricular
end-systolic pressure-volume relation. Sixteen dogs were previously
instrumented with micromanometer pressure transducers and three sets of
piezoelectric crystals to permit determination of left ventricular pressure
and volume. The dogs were studied after autonomic blockade and sedation.
End-systolic pressure- volume relations were generated by caval occlusion
at control levels of blood pressure, after infusion of a vasopressor
(methoxamine, n = 6; angiotensin II, n = 10), and then after infusion of
nitroprusside. A composite end-systolic pressure-volume relation was also
constructed with the use of control, vasopressor, and vasodilator points in
each dog. Angiotensin II resulted in a leftward shift in the relation (Vo
decreased from 14.32 +/- 7.3 to 8.04 +/- 10.4 ml, p less than .05) with no
significant effect on slope. Methoxamine shifted the relation to the left
(Vo decreased from 13.98 +/- 8.74 to -0.47 +/- 12.06 ml, p less than .05)
and also reduced the slope (5.41 +/- 3.09 vs 8.28 +/- 3.94 mm Hg/ml, p less
than .05).(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
The effect of vasoactive agents on the left ventricular end-systolic pressure-volume relation in closed-chest dogs
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