scholarly journals Left Ventricular Chamber Shape During Vena Caval Occlusion: Improved MRI-based Measurement of the End-Systolic Pressure-Volume Relationship in Normal Sheep

2019 ◽  
Author(s):  
Duc M. Giao ◽  
Yan Wang ◽  
Renan Rojas ◽  
Kiyoaki Takaba ◽  
Anusha Badathala ◽  
...  
Keyword(s):  
Cross Sections ◽  
Vena Cava ◽  
Systolic Pressure ◽  
Major Axis ◽  
Left Ventricular ◽  
Lv Function ◽  
Apical Level ◽  
Volume Relationship ◽  
Non Linear ◽  
Pressure Volume Relationship

AbstractThe left ventricular (LV) end-systolic pressure volume relationship (ES; ESPVR) is the cornerstone of systolic LV function analysis. Recently, it became possible to measure 2D LV chamber shape during vena cava occlusion (VCO) with MRI. We used an improved level-set semi-automatic segmentation method (LSSM) to determine the effect of VCO on LV geometry, ES pressure area (PA) and ESPVR.10 healthy adult sheep were anesthetized. LV pressure transducer and inferior vena cava (IVC) balloon catheter were percutaneously inserted. Ferumoxytol (0.125 ml/kg iv; AMAG Pharmaceuticals, Waltham, MA) was given to enhance blood pool contrast. LV pressure and 2D retrospectively-gated cine MRI of LV cross sections 25 (Apex), 50 (Mid) and 75% (Base) of the distance from the apex to the base of the LV were obtained during separate IVC balloon inflations (VCO). LV pressure was digitally filtered and LV chamber segmented with the LSSM. Cross sectional area, major and minor axes, major axis orientation, ESPAR and ESPVR were calculated.The LSSM had excellent reliability. All cross sections became more elliptical during VCO. The orientation (angle) of each major axis relative to the anterior RV insertion shifted during VCO. However, the orientation remained toward the septum. There was chamber collapse (LV area < 0.25 cm2) at the apical level during VCO (7 cases). ESPAR was non-linear at all levels. ESPVR was non-linear because of apical collapse.In conclusion, MRI-based measurement of LV geometry, ESPAR and ESPVR during VCO is a valuable method that may lead to improved understanding of systolic LV function.New and NoteworthyReal-time MRI was used to continuously measure the LV PA relationship as loading conditions were transiently varied in anesthetized sheep. All three examined cross-sections became more elliptical during VCO. The ESPAR were non-linear at all three cross-sections. Chamber collapse at the apical level during VCO resulted in a non-linear ESPVR. The heart contracted in a non-concentric manner during VCO which could inform modeling studies and elucidate mechanisms underlying LV adaptations to sudden load changes.

Left ventricular pressure-volume relationship in conscious mice

2007 ◽  
Vol 292 (1) ◽  
pp. H369-H377 ◽  
Author(s):  
Shuji Joho ◽  
Shinji Ishizaka ◽  
Richard Sievers ◽  
Elyse Foster ◽  
Paul C. Simpson ◽  
...  
Keyword(s):  
Systolic Pressure ◽  
Left Ventricular Pressure ◽  
Conscious State ◽  
Left Ventricular ◽  
Lv Function ◽  
Stroke Work ◽  
Polyethylene Tube ◽  
End Diastolic Volume ◽  
Volume Relationship ◽  
Pressure Volume Relationship

With the availability of transgenic models, the mouse has become an increasingly important subject for genetic-hemodynamic studies. Recently, we developed a technique to measure left ventricular (LV) pressure in conscious mice with an implanted LV polyethylene tube. We extended our new method by evaluating the LV pressure-volume relationship and examined the feasibility of this method in this study. We studied 17 male mice (age, 11–20 wk) with a conductance catheter inserted into the LV through the polyethylene tube. Load-independent parameters of contractility derived from pressure-volume relationship [slope of the end-systolic pressure-volume relationship ( Ees), slope of the maximum first derivative of LV pressure (dP/d tmax)-end-diastolic volume (EDV) relation, and preload-recruitable stroke work (PRSW)] were evaluated by inferior vena caval occlusion with an implanted snare. LV function assessed by this technique on two different days showed that the parameters were very similar, indicating reproducibility. Both linear and nonlinear regression analyses were performed for Ees. Contractility was enhanced by isoproterenol ( Ees, 13.1 ± 6.6 to 20.8 ± 8.7 mmHg/μl; dP/d tmax-EDV, 496 ± 139 to 825 ± 178 mmHg·s−1·μl−1; and PRSW, 110 ± 23 to 127 ± 21 mmHg), depressed by atenolol ( Ees, 14.5 ± 6.1 to 4.6 ± 2.0 mmHg/μl; dP/d tmax-EDV, 543 ± 188 to 185 ± 94 mmHg·s−1·μl−1; and PRSW, 117 ± 20 to 70 ± 15 mmHg) and isoflurane ( Ees, 12.3 ± 6.0 to 5.7 ± 2.1 mmHg/μl; dP/d tmax-EDV, 528 ± 172 to 164 ± 68 mmHg/s·μl; and PRSW, 124 ± 19 to 48 ± 10 mmHg), significantly. In conclusion, this is the first description of the LV pressure-volume relationship in conscious mice. These findings suggest that this method is feasible to detect changes of contractility in the conscious state, allowing serial assessment of pressure-volume-derived cardiac function indexes over time without anesthesia or repeated surgery.

scholarly journals Linear end-systolic pressure-volume relationship during pulsatile left ventricular bypass represents native heart function

1995 ◽  
Vol 109 (4) ◽  
pp. 780-786 ◽  
Author(s):  
Osamu Kawaguchi ◽  
John S. Sapirstein ◽  
William B. Daily ◽  
Walter E. Pae ◽  
William S. Pierce
Keyword(s):  
Heart Function ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Volume Relationship ◽  
Pressure Volume Relationship

Pressure-volume-based single-beat estimations cannot predict left ventricular contractility in vivo

2002 ◽  
Vol 282 (5) ◽  
pp. H1739-H1750 ◽  
Author(s):  
Knut E. Kjørstad ◽  
Christian Korvald ◽  
Truls Myrmel
Keyword(s):  
Systolic Pressure ◽  
Left Ventricular ◽  
Clinical Applications ◽  
Volume Data ◽  
Ventricular Contractility ◽  
Limits Of Agreement ◽  
Volume Relationship ◽  
Pressure Volume Relationship ◽  
State Pressure

The end-systolic pressure-volume relationship is regarded as a useful index for assessing the contractile state of the heart. However, the need for preload alterations has been a serious limitation to its clinical applications, and there have been numerous attempts to develop a method for calculating contractility based on one single pressure-volume loop. We have evaluated four of these methods. Pressure-volume data were obtained by combined pressure and conductance catheters in 37 pigs. All four methods were applied to 88 steady-state pressure-volume files, including eight files sampled during dopamine infusions. Estimates of single-beat contractility (elastance) were compared with preload-varied multiple-beat elastance [ E es(MB)]. All methods had a low average bias (−0.3 to 0.5 mmHg/ml) but limits of agreement (±2 SD) were unacceptably high (±2.6 to ±3.8 mmHg/ml). In the dopamine group, E es(MB) showed an increase of 1.7 ± 0.8 mmHg/ml (mean ± SD) compared with baseline ( P < 0.001). None of the single-beat methods predicted this increase in contractility. It is therefore doubtful whether any of the methods allow for single-beat assessment of contractility.

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

1988 ◽  
Vol 29 (5) ◽  
pp. 689-707 ◽  
Author(s):  
Kouichi TAKEDA ◽  
Takahiko SHIMIZU ◽  
Hideo YAMAMOTO ◽  
Shigeru YAGI
Keyword(s):  
Systolic Pressure ◽  
Left Ventricular ◽  
Cylinder Model ◽  
Volume Relationship ◽  
Pressure Volume Relationship

A New Non-Invasive Method for Assessing the Intrinsic Active Strength of Human Left Ventricular Tissue

2007 ◽  
Author(s):  
Tom E. Claessens ◽  
Ernst R. Rietzschel ◽  
Marc L. De Buyzere ◽  
Dirk De Bacquer ◽  
Guy De Backer ◽  
...  
Keyword(s):  
Systolic Pressure ◽  
Left Ventricular ◽  
Contractile State ◽  
Non Invasive ◽  
Left Ventricular Tissue ◽  
Ventricular Tissue ◽  
Volume Relationship ◽  
Invasive Method ◽  
Pressure Volume Relationship ◽  
Human Left Ventricle

The contractile state of the human left ventricle (LV) is often assessed by its end-systolic elastance (Ees) [1]. This index is calculated as the slope of the linear end-systolic pressure-volume relationship (ESPVR), which connects the upper left corners of pressure-volume loops obtained under various loading conditions (figure 1).

Single-beat evaluation of left ventricular inotropic state in conscious dogs

1989 ◽  
Vol 256 (1) ◽  
pp. H56-H65 ◽  
Author(s):  
E. C. Lascano ◽  
J. A. Negroni ◽  
J. G. Barra ◽  
A. J. Crottogini ◽  
R. H. Pichel
Keyword(s):  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Conscious Dogs ◽  
Time Data ◽  
Inotropic State ◽  
Volume Relationship ◽  
Pressure Volume Relationship ◽  
Experimental Findings ◽  
Parameter Values

Two competing left ventricular elastic-resistive (ER) models were used to predict parameter values from pressure, volume, and time data of a single ejective beat in conscious dogs during control, enhanced (dobutamine), and decreased (propranolol) inotropic states. The animals were instrumented with three pairs of microcrystals and a transducer to measure intraventricular volume and pressure. Results showed that with the ER nonlinear model (ERNL), parameter values in all animals lay within the physiological range. These were the slope (Emax) and the intercept (V0) of the isovolumic end-systolic pressure-volume relationship (ESPVR), the slope of the end-diastolic pressure-volume relationship (Ed), the time to Emax (Tmax), the normalized time to end of activation (A), and the resistive constant (K). In the two models, the normalized SE of the estimate of data fitting was below 0.2 Emax, as estimated from a single beat, responded to changes in contractility in a significantly more consistent fashion than the slope of ESPVRs (Ees) generated by preload maneuvers in conscious dogs. Single-beat estimated Tmax and K with the ERNL model did also respond consistently to contractility changes, whereas with the elastic resistive linear (ERL) model, K did not reproduce the experimental findings with decreased inotropic state. We conclude that 1) the ERNL model can be employed to assess contractility changes in conscious dogs from data of a single ejective beat, and 2) these changes are better indicated by single-beat estimated Emax than by Ees calculated from conventional ESPVRs.

Abstract 16333: Racial Differences in Pressure-volume Relationships in Val122Ile Associated Cardiac Amyloidosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jaya Batra ◽  
iacopo olivotto ◽  
Mathew S Maurer
Keyword(s):  
Racial Differences ◽  
Cardiac Amyloidosis ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Disease Phenotype ◽  
Cardiac Chamber ◽  
Volume Relationship ◽  
Pressure Volume Relationship ◽  
White Patients

Background: Transthyretin cardiac amyloidosis (ATTR-CA) is the leading cause of restrictive cardiomyopathy in older adults. The valine-to-isoleucine substitution (Val122Ile) is the most common inherited variant in the U.S., primarily affecting patients of Afro-Caribbean descent. This variant has also been identified in white individuals in Northern Italy who present with a similar disease phenotype. It is unknown whether there are between-race differences in cardiac chamber function at diagnosis of Val122Ile associated ATTR-CA. Methods: In this retrospective study of 70 patients from two amyloid centers with Val122Ile associated ATTR-CA diagnosed over two decades, clinical and echocardiographic features at diagnosis were compared between races. Cardiac chamber performance was compared using noninvasive, single beat pressure-volume analysis. Results: Average age at diagnosis was 72 years. Compared to white patients (n=17), black individuals (n=53) had lower systolic blood pressure (110 vs. 131 mmHg , p<0.001), reduced pulse pressure (41 vs. 58 mmHg, p<0.001), and impaired renal function (eGFR 46 vs. 67 mL/min/1.73m 2 , p<0.001) at the time of diagnosis. End-systolic pressure-volume relationship (2.3 vs. 1.9 mmHg/mL, p = 0.88), and arterial elastance (3.0 vs. 3.0 mmHg/mL, p = 1.0) were similar between groups (Panel A). Black patients had an end-diastolic pressure-volume relationship shifted upward and leftward relative to white patients, indicating reduced left ventricular capacity. Accordingly, pressure-volume area at a left ventricular end-diastolic pressure of 30 mmHg was lower in black compared to white individuals (8,415 vs. 11,538 mmHg*mL, p = 0.012, Panel B). Conclusion: Despite presenting at a similar age to white patients, black individuals with Val122Ile associated ATTR-CA have a greater degree of cardiac remodeling which drives reduced overall chamber function. These findings suggest a more aggressive disease phenotype.

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