Volume-tension diagrams of ejecting and isovolumic contractions in left ventricle

Taylor, RR; Jw, Covell; Ross, John F.

doi:10.1152/ajplegacy.1969.216.5.1097

Cited by 73 publications

(20 citation statements)

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“…27 The tension-length data at the end of ejection fell on a straight line ( fig. 4), whose slope was independent of end-diastolic volume and aortic impedance but was affected by acute changes in inotropic state.…”

Section: Discussionmentioning

confidence: 92%

“…4), whose slope was independent of end-diastolic volume and aortic impedance but was affected by acute changes in inotropic state. 6,6,14,27 Consequently, the end-systolic stressdimension line was proposed as a clinical index of myocardial contractility. '2 13, 16 Nevertheless, the need for hemodynamic interventions and for repeated ventriculograms to obtain a reasonable number of data points to fit this end-systolic line limits the clinical use of this superior index of contractility.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of left ventricular contractility from late systolic stress-volume relations.

Pouleur¹,

Rousseau²,

Eyll³

et al. 1982

Circulation

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SUMMARY The aim of the study was to determine if the end-systolic stress-end-systolic volume relation of the left ventricle (i.e., its tension-length relation) could be estimated from the analysis of a single yentriculogram. For that purpose, the left ventricular (LV) wall stress and volume were computed frame by frame in 35 patients (15 controls, 11 patients with valvular disease, six with coronary artery disease and three with congestive cardiomyopathy). In all patients, a linear relation was observed between LV wall stress and volume during approximately the last two-thirds of ejection. Under basal conditions, the duration of this linear relation ranged from 100-260 msec (mean 155 msec; mean r = 0.97) with a positive slope (range 3.0-9.3 kdyn/cm'/m' in controls) and a negative volume intercept. During a positive inotropic intervention (atrial pacing at 120 beats/min) that increased peak positive dP/dt by 24% (p < 0.0002), the Material and Methods PatientsThirty-five patients, mean age 45 years (range 18-59 years), were included in this study. All were in sinus rhythm and underwent diagnostic cardiac catheterization. Clinical and angiographic data are listed in table 1. Fifteen patients who had atypical chest pain and completely normal ventriculograms and coronary arteries were considered as normal control subjects. The other patients included 11 with valvular diseases, six with coronary artery disease (stenosis of 75% or greater in at least one coronary vessel) and three with congestive cardiomyopathy. All cardioactive drugs were discontinued at least 48 hours, in most cases 6-7 days, before the procedure. Each patient gave informed consent and no complication occurred as a result of this study.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Assessment of left ventricular contractility from late systolic stress-volume relations.

Pouleur¹,

Rousseau²,

Eyll³

et al. 1982

Circulation

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“…[1][2][3][4][5][6] ESPVR linearity enables a simple description in terms of a slope (Ees) and volume axis intercept (V0) and of a characterization of ventricular contraction by a time-varying elastance model. However, as techniques for ESPVR determination and the condition of experimental preparations have improved, nonlinearity of the relation has been increasingly observed.…”

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confidence: 99%

Influence of contractile state on curvilinearity of in situ end-systolic pressure-volume relations.

et al. 1989

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Although in situ end-systolic pressure-volume relations (ESPVRs) are approximately linear throughout a limited load range, they often yield seemingly "1negative" volume axis intercepts (V0) and V0 shifts with inotropic interventions. We tested whether or not these findings could stem from in situ ESPVR nonlinearity, and we examined the physiologic meaning and the slope of the dP/dtmax and end-diastolic volume relation, and the slope of the stroke work and end-diastolic volume relation. ESPVR was frequently curvilinear, and a significant correlation existed between the extent of nonlinearity (a) and contractile state. Volume intercepts derived from linear fits to the high load ESPVR range were mostly negative and were dependent on changes in Ees. V0 estimates derived from the low load portion were positive and relatively insensitive to Ees. Thus, in situ ESPVR displays contractility-dependent curvilinearity. The

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“…Based on the results obtained from the myocardial total force-length relation at the end of systole,2)-4) new measures independent of both preload and afterload have been proposed as the best end-systolic indices for evaluating myocardial contractility in the intact heart, i.e., the slopes of the left ven-tricular (LV) end-systolic pressure-volume (Pes-Ves),5)-7) stress-length, 8) pressure-dimension (Pes-Des),9) and stress-strain10) relations. Suga et al6) (1973) initially suggested the usefulness of these slopes as new indices of myocardial contractility in the intact heart.…”

mentioning

confidence: 99%

Human left ventricular end-systolic pressure-volume relationship in a cylinder model.

et al. 1988

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SUMMARYThe relationship between myocardial total force and length at the end of systole appears to be linear, and the slope of this relationship is considered to be an appropriate index of myocardial contractile state, independent of preload and afterload. However, direct measurements of this relation may be impossible in the intact human heart, and thus, alternative indices such as the left ventricular end-systolic stress-length, stressstrain, pressure-volume, and pressure-dimension slopes have been proposed to evaluate myocardial contractility in the intact heart. However, the mathematical relationship between the myocardial end-systolic total force-length relation and any of these left ventricular end-systolic relations remains unclear. In this study, assuming a linear myocardial endsystolic total force-length relation in an intact ventricle, we obtained mathematical formulae for the left ventricular end-systolic stress-strain, pressure-radius, and pressure-volume relations, using a cylinder model of the left ventricle. The results obtained using these formulae and the cylinder model were found to match accurately findings obtained from earlier experimental and clinical studies of these left ventricular end-systolic relations. Thus, this model could mathematically account for the relationships between the slopes of the myocardial end-systolic total forcelength relation and these left ventricular end-systolic relations. slope of the LV end-systolic pressure-radius rela-

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Volume-tension diagrams of ejecting and isovolumic contractions in left ventricle

Cited by 73 publications

References 0 publications

Assessment of left ventricular contractility from late systolic stress-volume relations.

Assessment of left ventricular contractility from late systolic stress-volume relations.

Influence of contractile state on curvilinearity of in situ end-systolic pressure-volume relations.

Human left ventricular end-systolic pressure-volume relationship in a cylinder model.

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