Measurement of end-systolic pressure-volume relations by intra-aortic balloon occlusion.

Gupta, Krishanu B.; Bavaria, Joseph E.; Ratcliffe, Mark B.; Edmunds, L. Henry; Bogen, Daniel K.

doi:10.1161/01.cir.80.4.1016

Cited by 15 publications

(10 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the linear ESPVR, two descriptors were calculated; the slope, or E e " and the V14. VI4 was used rather than Vd because the ESPVR has been demonstrated to be nonlinear to some extent in many preparations (24)(25)(26)(27)(28). Thus, extrapolation beyond the range of measurement is undesirable.…”

Section: Methodsmentioning

confidence: 99%

“…PV loops have been analyzed by a variety of techniques (13,14,35,(44)(45)(46), but most commonly by generating ESPVR, to assess ventricular function in control conditions and in response to various hemodynamic perturbations. There have, however, been several concerns about the ESPVR, including those of nonlinearity both outside and within the range of measurement (24)(25)(26)(27)(28), load dependency, particularly related to the technique of generating the relationship itself (13,IS,23,29), and relative insensitivity to changes in contractility (43). We have recently performed studies validating the accuracy of the conductance catheter in the in situ newborn heart (37), and undertook the present study to critically analyze the ESPVR in the newborn.…”

Section: Parallel Conductance Versus Esv and Edvmentioning

confidence: 97%

“…In the adult, the ESPVR has been shown to be relatively sensitive to changes in inotropic state (15,17,19,23), but evidence of nonlinearity (24)(25)(26)(27)(28) and afterload sensitivity (13,23,29,30) has been found. It is uncertain whether such problems would be more or less important in the newborn.…”

mentioning

confidence: 99%

“…Pressure deficits during ejection probably do occur to some extent, caused by shortening deactivation and the internal resistance of series elastic elements. Recent studies in the adult dog have shown nonlinearity in a variety of settings, including high contractile states (25,26), over a wide range of preload (27,28) and during balloon aortic occlusion (24). The nonlinearity was considered significant only in those studies performed over a high range in preload (27,28), in which stroke volume changes greatly and thus quite variable pressure deficits can occur during the generation of the ESPVR.…”

mentioning

confidence: 99%

See 3 more Smart Citations

The End-Systolic Pressure-Volume Relationship in the Newborn Lamb: Effects of Loading and Inotropic Interventions

et al. 1991

View full text Add to dashboard Cite

ABSTRACT. Indices of global systolic performance of the newborn left ventricle exceed those of the adult, despite isolated tissue studies showing immature contractile mechanisms. To evaluate contractility in situ, we investigated the end-systolic pressure-volume relationship (ESPVR) by the conductance technique in nine newborn lambs. After percutaneous placement of catheters, we generated ESPVR by inferior vena cava occlusion, aortic occlusion, and volume infusion in two control states, during three levels of dobutamine infusion, and after propranolol. We performed linear and nonlinear regression analyses of the end-systolic points and derived the slope (E.,) and volume at 14 kPa pressure. We found that reliable ESPVR could be obtained in almost all inferior vena cava and aortic occlusions (50 of 51 in each), but in only 18 of 27 volume infusions. Overall, linear regressions adequately defined the ESPVR (75 of 102 were not statistically different than nonlinear regressions; of those different, the mean linear R 2 was 0.934 ± 0.048). By multiple regression analysis, neither E es nor volume at 14 kPa significantly changed with dobutamine, but both changed after propranolol (23% less than control and 54% greater, respectively), supporting previous studies showing a limited contractile reserve in the newborn secondary to high resting p-adrenergic tone. Neither E., nor volume at 14 kPa was different between control states. However, E e , was 25% less steep when generated by inferior vena cava than by aortic occlusion. We conclude that the ESPVR can be generated reliably and reproducibly in the newborn lamb and is relatively linear and sensitive to changes in contractility, but that it is also sensitive to the technique of load intervention.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Parallel Conductance Versus Esv and Edvmentioning

confidence: 97%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

The End-Systolic Pressure-Volume Relationship in the Newborn Lamb: Effects of Loading and Inotropic Interventions

et al. 1991

View full text Add to dashboard Cite

show abstract

“…19 A custom-made 50-mL intra-aortic balloon (Datascope, Inc) was placed during fluoroscopy in the aortic root from the femoral artery and was connected to a System 90-T intra-aortic balloon pump (Datascope Inc). The balloon was triggered to inflate during diastole and to remain inflated during the following contraction.…”

Section: End-systolic Elastancementioning

confidence: 99%

Restraining Infarct Expansion Preserves Left Ventricular Geometry and Function After Acute Anteroapical Infarction

et al. 1999

View full text Add to dashboard Cite

Background-Expansion of an acute myocardial infarction predicts progressive left ventricular (LV) dilatation, functional deterioration, and early death. This study tests the hypothesis that restraining expansion of an acute infarction preserves LV geometry and resting function. Methods and Results-In 23 sheep, snares were placed around the distal left anterior descending and second diagonal coronary arteries. In 12 sheep, infarct deformation was prevented by Marlex mesh placed over the anticipated myocardial infarct. Snared arteries were occluded 10 to 14 days later. Serial hemodynamic measurements and transdiaphragmatic quantitative echocardiograms were obtained up to 8 weeks after anteroapical infarction of 0.23 of LV mass. In sheep with mesh, circulatory hemodynamics, stroke work, and end-systolic elastance return to preinfarction values 1 week after infarction and do not change subsequently. Ventricular volumes and ejection fraction do not change after the first week postinfarction. Control animals develop large anteroapical ventricular aneurysms, increasing LV dilatation, and progressive deterioration in circulatory hemodynamics and ventricular function. At week 8, differences in LV end-diastolic pressure, cardiac output, end-diastolic and end-systolic volumes, ejection fraction, stroke work, and end-systolic elastance are significant (PϽ0.01) between groups. Conclusions-Preventing expansion of acute myocardial infarctions preserves LV geometry and function. (Circulation.1999;99:135-142.)

show abstract

Myocardial Dysfunction in Experimental Septic Shock

Krösl

Pretorius

1993

Pathophysiology of Shock, Sepsis, and Organ Failure

View full text Add to dashboard Cite

Measurement of end-systolic pressure-volume relations by intra-aortic balloon occlusion.

Abstract: (Circulation 1989;80:1016-1028

Cited by 15 publications

References 60 publications

The End-Systolic Pressure-Volume Relationship in the Newborn Lamb: Effects of Loading and Inotropic Interventions

The End-Systolic Pressure-Volume Relationship in the Newborn Lamb: Effects of Loading and Inotropic Interventions

Restraining Infarct Expansion Preserves Left Ventricular Geometry and Function After Acute Anteroapical Infarction

Myocardial Dysfunction in Experimental Septic Shock

Contact Info

Product

Resources

About