Evaluation of contractility and postloading in the intensive care unit

Aim: The impact of reduced myocardial contractility on patients’ outcomes with advanced heart failure (HF) and the correct measurement units for its measure is most important. The present work aims to evaluate the prognostic value of the left ventricular stroke work index (LVSWI), which is considered a measure of myocardial contractility, in patients with advanced HF. Material and Methods: Between September 2010 and July 2013, 172 patients with advanced HF admitted to the hospital to guide the specified therapies were included in this study. At baseline, patients were assessed with cardiac catheter-based hemodynamic measurements, ensued by the longitudinal follow-up (median of 52 months) for adverse outcomes (cardiac mortality, ventricular assist device (VAD) placement, and heart transplant (HTx)). Results: Median LVSWI was 16 cJ/m2. Decreased LVSWI (

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“…Cox regression (proportional hazards) models outcomes, which could be related to the fact that the LVSWI is independent of heart rate[21].…”

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confidence: 99%

İleri evre kalp yetmezliği olan hastalarda sol ventriküler atım iş indeksinin prognostik değeri

Yıldız

Yenigun

2022

Turkish Journal of Clinics and Laboratory

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“…">IntroductionThe end-systolic pressure-volume relation (ESPVR) is the relation between pressure and volume in the left or right ventricle when the myocardium reaches its maximum state of activation during the contraction phase, possible clinical application of this relation has been extensively studied [1][2][3][4][5][6][7][8][9][10]. The mathematical model used in this study has been derived in previous publications [8][9][10], it is based on the theory of large elastic deformation of the myocardium.…”

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confidence: 99%

The Pressure Gradient across the Endocardium

Shoucri

2016

2016 Computing in Cardiology Conference (CinC)

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A mathematical formalism for the non-linear endsystolic pressure-volume relation (ESPVR) in the heart ventricles has the interesting feature that the peak active pressure generated by the myocardium ( IntroductionThe end-systolic pressure-volume relation (ESPVR) is the relation between pressure and volume in the left or right ventricle when the myocardium reaches its maximum state of activation during the contraction phase, possible clinical application of this relation has been extensively studied [1][2][3][4][5][6][7][8][9][10]. The mathematical model used in this study has been derived in previous publications [8][9][10], it is based on the theory of large elastic deformation of the myocardium. An interesting feature of this model is the introduction of the peak active force generated by the myocardium in the mathematical formalism describing the non-linear ESPVR. When inertia forces and viscous forces are neglected, the peak active force generated by the myocardium can be equated to the peak isovolumic pressure Pisom generated by the myocardium in a non-ejecting contraction. Non-invasive calculation of the ratio (Pisom -Pm)/Pm is possible with the mathematical formalism used, and in this study we show how this ratio can be used for the purpose of segregation and classification of different clinical groups. This index can be related to the study of the problem of heart failure (HF) with normal or preserved ejection (HFpEF) as will be indicated, HFpEF is defined as HF with EF > 0.5 [7].In what follows we first review the mathematical formalism used, then we present some applications to clinical data published in the literature [11][12][13][14] Mathematical formalismThe left ventricle is represented as a thick-walled cylinder contracting symmetrically [8-10] (see Fig. 1). During the contraction phase, the myocardium generates a radial active force per unit volume of the myocardium designated by Dr, which force will develop an active pressure ∫a b Dr dr ≈ Piso on the inner surface of the myocardium (endocardium), a = inner radius, b = outer radius, h = b -a = thickness of the myocardium. In a quasi-static approximation (inertia and viscous forces neglected), the equilibrium of forces on the endocardium can be expressed in the form Piso -P = E2 (Ved -V)P is the LV pressure, V the LV volume and it is indicated as Ved at end-diastole (when dV/dt = 0), E2 is an elastance coefficient that relates the difference of pressures Piso -P to the difference of volumes Ved -V. Near end-systole when the myocardium reaches its maximum state of activation, Eq. (1) can be expressed in the formVm ≈ Ves (Ves the end-systolic volume when dV/dt = 0), Pisom, Pm, and Vm are as defined in Eq. (1) but measured at the moment when the myocardium reaches its maximum state of activation. Figure 2 represents a non-linear ESPVR shown as the curve BDC, it is the relation obtained when Pm and Vm are varied and the peak isovolumic pressure Pisom is kept constant (as if a balloon is inflated against a constant Pisom). From Fig.2, E2m = ...

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“…Sin embargo en los pacientes críticos tiene limitaciones ya que requiere la visualización del endocardio para su determinación y la ventana de imagen ecocardiográfica puede estar limitada por el uso de VMI, la PEEP elevada, tubos torácicos, drenajes y la posición del paciente que con frecuencia no puede girarse a decúbito lateral izquierdo con inclinación de 90º como en los gabinetes de ecocardiografía. Además no es un estimador útil de la función contráctil en situaciones que alteren la postcarga cardiaca (65).…”

Section: Disfunción Sistólica De Ventrículo Izquierdo (Dsvi)unclassified

Disfunción moicárdica en la sepsis: utilidad de la ecocardiografía y los biomarcadores

Gutiérrez¹

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9.1 Formulario de recogida de datos……………………………………….193 9.2 Microorganismos aislados en el laboratorio……………………….. 207 9.3 Calidad de ventana y ritmo auricular en los ETT…………………… 208 9.4 Matriz de correlaciones de BNP y TnI con variables ecocardiográficas en los días 1 y 3…………………………………..... 209 9.5 Matriz de correlaciones de BNP y TnI con SOFA,

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Evaluation of contractility and postloading in the intensive care unit

Cited by 5 publications

References 39 publications

İleri evre kalp yetmezliği olan hastalarda sol ventriküler atım iş indeksinin prognostik değeri

İleri evre kalp yetmezliği olan hastalarda sol ventriküler atım iş indeksinin prognostik değeri

The Pressure Gradient across the Endocardium

Disfunción moicárdica en la sepsis: utilidad de la ecocardiografía y los biomarcadores

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