The Relationship of Alterations in Systolic Time Intervals to Ejection Fraction in Patients with Cardiac Disease

Abstract

The relationships between the systolic time intervals determined from simultaneous recordings of the electrocardiogram, the phonocardiogram, the carotid arterial pulse tracing, and direct measures of left ventricular performance as assessed angiographically by measurement of left ventricular stroke volume (SV), end-diastolic volume (EDV), and ejection fraction (EF) were studied in 68 patients with a wide variety of cardiac diseases. The systolic intervals, the pre-ejection period (PEP), the left ventricular ejection time (LVET), and the ratio PEP/LVET, each correlated significantly with angiographically determined EF and EDV. Closest correlation was observed between PEP/LVET and EF (r = -0.90). The systolic intervals correlated only slightly with the angiographically determined SV. These data lend additional evidence supporting the use of systolic time intervals as a non-invasive measure of left ventricular performance in patients with cardiac disease.

A new systolic parameter defined as the ratio of brachial pre-ejection period to brachial ejection time predicts overall and cardiovascular mortality in hemodialysis patients

“…In left ventricular decompensation, the extent of fiber shortening is decreased, so a shortened ET is usually noted. 4 As heart function impairment usually prolongs PEP and shortens ET, the ratio of PEP to ET may enhance the diagnostic value for the identification of left ventricular dysfunction. Our recent study showed that bPEP, bET and bPEP/bET had a significant correlation with left ventricular ejection fraction and bPEP/bET had a higher accuracy in prediction of left ventricular ejection fraction o50% than bPEP and bET.…”

“…3 Prolonged pre-ejection period (PEP) and shortened ejection time (ET) have been reported to be significantly correlated with decreased left ventricular systolic function. [3][4][5] A high correlation (r¼À0.90) between PEP/ET and left ventricular ejection fraction has been shown in patients with a wide variety of heart disease. 4 However, PEP and ET are frequently obtained from echocardiography, which may preclude their application in evaluating left ventricular systolic function if echocardiography is not available.…”

“…[3][4][5] A high correlation (r¼À0.90) between PEP/ET and left ventricular ejection fraction has been shown in patients with a wide variety of heart disease. 4 However, PEP and ET are frequently obtained from echocardiography, which may preclude their application in evaluating left ventricular systolic function if echocardiography is not available. A clinical device, ankle-brachial index (ABI)-form (Colin VP1000, Komaki, Japan), has been developed to automatically and simultaneously measure blood pressures in both arms and ankles and record pulse waves of the brachial and posterior tibial arteries, using an automated oscillometric method.…”

Use of the systolic time intervals in clinical pharmacology.

“…This clear difference from any acute, drug-induced alteration in left ventricular function is confirmed by other studies which demonstrate that 'indices of contractility' perform very poorly in detecting clinical left ventricular disease (Peterson, Skloven, Ludbrook, Utmer & Ross, 1974;Kreulen, Bove, McDonough, Sands & Spann, 1975). The ratio PEP/LVET has been shown to be related to ejection fraction (LV stroke volume/end-diastolic volume) Garrard et al, 1970) which itself is a ratio and therefore dimensionless rather than time related. A second factor likely to prolong PEP and thus delay the onset of ejection is the presence of incoordinate left ventricular wall movement during isovolumic contraction.…”

Influence of atenolol and nifedipine on digoxin‐induced inotropism in humans.

“…As previously mentioned atenolol elicited nodal rhythm in one subject. Discussion STI and echocardiography have become widespread methods for the estimation of myocardial performance (Garrard et al, 1970;Feigenbaum, 1976). In particular in situations where serial measurements are necessary or in healthy subjects where invasive methods are ethically unacceptable.…”