Identification of left ventricular volume regulation on the basis of the elastance concept

Kerkhof, Peter L. M.; Li, J.K.-J.

doi:10.1109/iembs.2002.1106354

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…56 Along the theoretical line, we clarified the role of ASC versus classical Starling curve 63 and the mathematical connection between ASC determinants and the systolic elastance concept. 66,68 Finally, we dismantled the presumed pivotal role of EF, developed a Monte Carlo simulation model for HF phenotype transitions, 69 and formulated the dependence of LV-arterial coupling on the characteristics of the ASC. 70 Recently, we replaced the term ASC by VRG because the former unintendedly seems to suggest that Starling's law is of minor importance, while the latter abbreviation more appropriately focuses on the central issue regarding regulation of LV volume.…”

Section: Heart Failurementioning

confidence: 99%

“…92 Results are illustrated in Figure 6, suggesting a correspondence between ESVI and Vo as previously reported. 68,93 In conscious, autonomically intact dogs, the use of stepwise, steady-state afterload variations to obtain ESP-ESV data points was employed to construct the systolic elastance curve. 94 Unfortunately, incorrect estimates for E max were found.…”

Section: Volume Domain Representation and Systolic Elastance Conceptmentioning

confidence: 99%

“…Thus, EF must be interpreted in its clinical context. 71 Since EF is not a universal indicator of LV performance, it has been suggested that EF rather reflects k. Indeed with the inclusion of several assumptions, it is possible to derive a relationship between EF and k. Additionally, it has been demonstrated that the regression coefficients of the VRG are related 68 to k and to the intercept Vo of the E max relationship:…”

Section: What Is Ef?mentioning

confidence: 99%

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Characterizing Heart Failure in the Ventricular Volume Domain

Kerkhof

2015

Clin Med Insights Cardiol

101

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Heart failure (HF) may be accompanied by considerable alterations of left ventricular (LV) volume, depending on the particular phenotype. Two major types of HF have been identified, although heterogeneity within each category may be considerable. All variants of HF show substantially elevated LV filling pressures, which tend to induce changes in LV size and shape. Yet, one type of HF is characterized by near-normal values for LV end-diastolic volume (EDV) and even a smaller end-systolic volume (ESV) than in matched groups of persons without cardiac disease. Furthermore, accumulating evidence indicates that, both in terms of shape and size, in men and women, the heart reacts differently to adaptive stimuli as well as to certain pharmacological interventions. Adjustments of ESV and EDV such as in HF patients are associated with (reverse) remodeling mechanisms. Therefore, it is logical to analyze HF subtypes in a graphical representation that relates ESV to EDV. Following this route, one may expect that the two major phenotypes of HF are identified as distinct entities localized in different areas of the LV volume domain. The precise coordinates of this position imply unique characteristics in terms of the actual operating point for LV volume regulation. Evidently, ejection fraction (EF; equal to 1 minus the ratio of ESV and EDV) carries little information within the LV volume representation. Thus far, classification of HF is based on information regarding EF combined with EDV. Our analysis shows that ESV in the two HF groups follows different patterns in dependency of EDV. This observation suggests that a superior HF classification system should primarily be founded on information embodied by ESV.

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Section: Heart Failurementioning

confidence: 99%

Section: Volume Domain Representation and Systolic Elastance Conceptmentioning

confidence: 99%

Section: What Is Ef?mentioning

confidence: 99%

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Characterizing Heart Failure in the Ventricular Volume Domain

Kerkhof

2015

Clin Med Insights Cardiol

101

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“…In fact, the mere analysis of dimensional measurements has been demonstrated to yield crucial insight into LV pump function [2,3]. When end-systolic dimension is plotted versus end-diastolic dimension (often denoted as preload), we obtain a fairly linear relationship, similar to the wellknown Starling curve which depicts output (in terms of stroke volume or work) as a function of preload.…”

Section: H H H Hemodynamic Interventions and The Pressure-diameter Lomentioning

confidence: 99%

H emodynamic Interventions and the Pressure-Diameter Loop of the Left Ventricle and the Proximal Aorta in the Conscious Dog

Kerkhof¹,

Li²

The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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The dynamics of the left ventricle (LV) have been extensively investigated. However, most studies refer to steady state conditions. We addressed the beat-to-beat variations resulting from hemodynamic interventions analyzed in the chronically instrumented dog. This approach permits serial studies in the same subject under physiological conditions. In particular we investigated the end-systolic pressure-dimension relationship and characteristics of the proximal aorta. The findings obtained during basal conditions, exercise and pharmacologic intervention indicate that several universal regulatory mechanisms are involved, besides various phenomena that exhibit a substantial degree of variability.

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Calculation of parameters of end-systolic pressure–volume relation in the ventricles

Shoucri

2011

Mathematical and Computer Modelling

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Identification of left ventricular volume regulation on the basis of the elastance concept

Cited by 4 publications

References 5 publications

Characterizing Heart Failure in the Ventricular Volume Domain

Characterizing Heart Failure in the Ventricular Volume Domain

H emodynamic Interventions and the Pressure-Diameter Loop of the Left Ventricle and the Proximal Aorta in the Conscious Dog

Calculation of parameters of end-systolic pressure–volume relation in the ventricles

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