Assessment of regional myocardial performance with end-systolic pressure length and thickness relationships

Theo E. Meyer, Stefano Perlini, Luciano Bernardi, Pier L. Sold'a, Alessandro Calciati, Pierre Foëx

Research output: Contribution to journalArticle

Abstract

Although end-systolic pressure length and thickness relationships (ESPLR, ESPTR) are now widely used as substitutes for the end-systolic pressure volume relationships, there are some reservations about their use as an index of left ventricular (LV) performance. This study addressed three issues, namely: (1) which loading technique (decreasing preload by inferior vena cava (IVC) balloon occlusion or increasing systolic pressure by aortic constriction) is the most likely to yield usable data; (2) reproducibility of these relationships over a 30 min period; and (3) whether by using end-ejection (zero aortic flow) as a definition of end-systole, ESPLR and ESPTR can be used to characterize myocardial performance independent of load. Thirteen anesthetized beagles, weighing 16-25 kg, were used for this study, and were instrumented with sonomicrometers. We found that when ESPLR and ESPTR were constructed from data derived during aortic constriction, the slopes of these relationships were steeper and more curvilinear than when they were constructed from data recorded during IVC occlusion. In addition, the mean difference between ESPLR, ESPTR obtained 30 min apart was small, although there was a fair degree of variability between the first and second measurements. Using end-ejection to define end-systole, both ESPLR and ESPTR were relatively insensitive to loading conditions (LV end-diastolic pressure of 8-12 mmHg and 14-18 mmHg, aortic systolic pressure of 7-10 mmHg and 20-25 mmHg above baseline (in terms of the slope and shift (leftward or rightward) in these relationships, but were sensitive to inotropic interventions (dobutamine 2.5 μg/kg per min and 5 μg/kg per min). We conclude that, ESPLR and ESPTR, defined from measurements at end-ejection, can be used as adequate descriptors of regional myocardial performance if they were constructed from data over a similar pressure range during IVC balloon occlusion.

Original languageEnglish
Pages (from-to)197-216
Number of pages20
JournalInternational Journal of Cardiology
Volume42
Issue number3
DOIs
Publication statusPublished - Dec 31 1993

Fingerprint

Blood Pressure
Inferior Vena Cava
Balloon Occlusion
Systole
Constriction
Dobutamine
Arterial Pressure
Pressure

Keywords

  • Anesthetics
  • Biology, physiology
  • Heart, mechanics
  • Heart, myocardinal function
  • Heart, regional contractility
  • Regional function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Assessment of regional myocardial performance with end-systolic pressure length and thickness relationships. / Meyer, Theo E.; Perlini, Stefano; Bernardi, Luciano; Sold'a, Pier L.; Calciati, Alessandro; Foëx, Pierre.

In: International Journal of Cardiology, Vol. 42, No. 3, 31.12.1993, p. 197-216.

Research output: Contribution to journalArticle

Meyer, Theo E. ; Perlini, Stefano ; Bernardi, Luciano ; Sold'a, Pier L. ; Calciati, Alessandro ; Foëx, Pierre. / Assessment of regional myocardial performance with end-systolic pressure length and thickness relationships. In: International Journal of Cardiology. 1993 ; Vol. 42, No. 3. pp. 197-216.
@article{375ad59d1090478ba5ec255323a4bfb8,
title = "Assessment of regional myocardial performance with end-systolic pressure length and thickness relationships",
abstract = "Although end-systolic pressure length and thickness relationships (ESPLR, ESPTR) are now widely used as substitutes for the end-systolic pressure volume relationships, there are some reservations about their use as an index of left ventricular (LV) performance. This study addressed three issues, namely: (1) which loading technique (decreasing preload by inferior vena cava (IVC) balloon occlusion or increasing systolic pressure by aortic constriction) is the most likely to yield usable data; (2) reproducibility of these relationships over a 30 min period; and (3) whether by using end-ejection (zero aortic flow) as a definition of end-systole, ESPLR and ESPTR can be used to characterize myocardial performance independent of load. Thirteen anesthetized beagles, weighing 16-25 kg, were used for this study, and were instrumented with sonomicrometers. We found that when ESPLR and ESPTR were constructed from data derived during aortic constriction, the slopes of these relationships were steeper and more curvilinear than when they were constructed from data recorded during IVC occlusion. In addition, the mean difference between ESPLR, ESPTR obtained 30 min apart was small, although there was a fair degree of variability between the first and second measurements. Using end-ejection to define end-systole, both ESPLR and ESPTR were relatively insensitive to loading conditions (LV end-diastolic pressure of 8-12 mmHg and 14-18 mmHg, aortic systolic pressure of 7-10 mmHg and 20-25 mmHg above baseline (in terms of the slope and shift (leftward or rightward) in these relationships, but were sensitive to inotropic interventions (dobutamine 2.5 μg/kg per min and 5 μg/kg per min). We conclude that, ESPLR and ESPTR, defined from measurements at end-ejection, can be used as adequate descriptors of regional myocardial performance if they were constructed from data over a similar pressure range during IVC balloon occlusion.",
keywords = "Anesthetics, Biology, physiology, Heart, mechanics, Heart, myocardinal function, Heart, regional contractility, Regional function",
author = "Meyer, {Theo E.} and Stefano Perlini and Luciano Bernardi and Sold'a, {Pier L.} and Alessandro Calciati and Pierre Fo{\"e}x",
year = "1993",
month = "12",
day = "31",
doi = "10.1016/0167-5273(93)90050-Q",
language = "English",
volume = "42",
pages = "197--216",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

TY - JOUR

T1 - Assessment of regional myocardial performance with end-systolic pressure length and thickness relationships

AU - Meyer, Theo E.

AU - Perlini, Stefano

AU - Bernardi, Luciano

AU - Sold'a, Pier L.

AU - Calciati, Alessandro

AU - Foëx, Pierre

PY - 1993/12/31

Y1 - 1993/12/31

N2 - Although end-systolic pressure length and thickness relationships (ESPLR, ESPTR) are now widely used as substitutes for the end-systolic pressure volume relationships, there are some reservations about their use as an index of left ventricular (LV) performance. This study addressed three issues, namely: (1) which loading technique (decreasing preload by inferior vena cava (IVC) balloon occlusion or increasing systolic pressure by aortic constriction) is the most likely to yield usable data; (2) reproducibility of these relationships over a 30 min period; and (3) whether by using end-ejection (zero aortic flow) as a definition of end-systole, ESPLR and ESPTR can be used to characterize myocardial performance independent of load. Thirteen anesthetized beagles, weighing 16-25 kg, were used for this study, and were instrumented with sonomicrometers. We found that when ESPLR and ESPTR were constructed from data derived during aortic constriction, the slopes of these relationships were steeper and more curvilinear than when they were constructed from data recorded during IVC occlusion. In addition, the mean difference between ESPLR, ESPTR obtained 30 min apart was small, although there was a fair degree of variability between the first and second measurements. Using end-ejection to define end-systole, both ESPLR and ESPTR were relatively insensitive to loading conditions (LV end-diastolic pressure of 8-12 mmHg and 14-18 mmHg, aortic systolic pressure of 7-10 mmHg and 20-25 mmHg above baseline (in terms of the slope and shift (leftward or rightward) in these relationships, but were sensitive to inotropic interventions (dobutamine 2.5 μg/kg per min and 5 μg/kg per min). We conclude that, ESPLR and ESPTR, defined from measurements at end-ejection, can be used as adequate descriptors of regional myocardial performance if they were constructed from data over a similar pressure range during IVC balloon occlusion.

AB - Although end-systolic pressure length and thickness relationships (ESPLR, ESPTR) are now widely used as substitutes for the end-systolic pressure volume relationships, there are some reservations about their use as an index of left ventricular (LV) performance. This study addressed three issues, namely: (1) which loading technique (decreasing preload by inferior vena cava (IVC) balloon occlusion or increasing systolic pressure by aortic constriction) is the most likely to yield usable data; (2) reproducibility of these relationships over a 30 min period; and (3) whether by using end-ejection (zero aortic flow) as a definition of end-systole, ESPLR and ESPTR can be used to characterize myocardial performance independent of load. Thirteen anesthetized beagles, weighing 16-25 kg, were used for this study, and were instrumented with sonomicrometers. We found that when ESPLR and ESPTR were constructed from data derived during aortic constriction, the slopes of these relationships were steeper and more curvilinear than when they were constructed from data recorded during IVC occlusion. In addition, the mean difference between ESPLR, ESPTR obtained 30 min apart was small, although there was a fair degree of variability between the first and second measurements. Using end-ejection to define end-systole, both ESPLR and ESPTR were relatively insensitive to loading conditions (LV end-diastolic pressure of 8-12 mmHg and 14-18 mmHg, aortic systolic pressure of 7-10 mmHg and 20-25 mmHg above baseline (in terms of the slope and shift (leftward or rightward) in these relationships, but were sensitive to inotropic interventions (dobutamine 2.5 μg/kg per min and 5 μg/kg per min). We conclude that, ESPLR and ESPTR, defined from measurements at end-ejection, can be used as adequate descriptors of regional myocardial performance if they were constructed from data over a similar pressure range during IVC balloon occlusion.

KW - Anesthetics

KW - Biology, physiology

KW - Heart, mechanics

KW - Heart, myocardinal function

KW - Heart, regional contractility

KW - Regional function

UR - http://www.scopus.com/inward/record.url?scp=0027744442&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027744442&partnerID=8YFLogxK

U2 - 10.1016/0167-5273(93)90050-Q

DO - 10.1016/0167-5273(93)90050-Q

M3 - Article

C2 - 8138328

AN - SCOPUS:0027744442

VL - 42

SP - 197

EP - 216

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 3

ER -