This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kreulen, T. H. Articles by Spann, J. F. Search for Related Content PubMed PubMed Citation Articles by Kreulen, T. H. Articles by Spann, J. F.

Circulation, Vol 51, 677-688, Copyright © 1975 by American Heart Association

ARTICLES

The evaluation of left ventricular function in man. A comparison of methods

TH Kreulen, AA Bove, MT McDonough, MJ Sands and JF Spann

Comparisons of the sensitivities of parameters for assessing left ventricular performance in man were made in 38 patients. The parameters compared were the ejection fraction, ventriculographic contraction patterns, the left ventricular end-diastolic pressure, and the contractile indices including the contractile element velocity at 10 mm Hg (Vce 10) and maximal contractile element velocity (Vmax). The contractile indices were obtained by catheter tip manometry, utilizing developed pressure (DP) to calculate the velocity of contractile element shortening (Vce) from the formula: dp/dt divided by 32 DP. Vce 10 was measured directly and Vmax was derived by linear manual extrapolation of the pressure-velocity plot to 0 mm Hg. Vmax values derived from linear manual extrapolation were compared with values obtained by computer least squares fitting of the Vce and developed pressure data points to single and double exponential equations. The Vce and developed pressure data points fit the single exponential equation better than the double exponential equation but the use of either equation resulted in slightly higher values for Vmax than obtained with linear manual extrapolation. The effect of heart rate on myocardial contractility was eliminated by making comparisons at both a basal and atrial paced rate of 100. Utilizing all methods, 24 patients were identified to have ventricular dysfunction. The contractile indices were significantly less sensitive than any other parameter (P smaller than 0.05) and identified seven patients while the left ventricular end-diastolic pressure, ejection fraction, and presence of asynergy identified 15, 15, and 12 patients, respectively. The use of a common atrial paced rate of 100 did not increase the sensitivity of the contractile indices. Since there was only partial overlapping between parameters in the identification of left ventricular dysfunction, the combination of different parameters was more sensitive than any single parameter alone. It is concluded that several methods are required to identify all patients with left ventricular dysfunction and that the contractile indices are the least sensitive indicator of left ventricular dysfunction.

This article has been cited by other articles:

				K. A. Connelly, D. L. Prior, D. J. Kelly, M. P. Feneley, H. Krum, and R. E. Gilbert Load-sensitive measures may overestimate global systolic function in the presence of left ventricular hypertrophy: a comparison with load-insensitive measures Am J Physiol Heart Circ Physiol, April 1, 2006; 290(4): H1699 - H1705. [Abstract] [Full Text] [PDF]

				B. A. Carabello Evolution of the Study of Left Ventricular Function: Everything Old Is New Again Circulation, June 11, 2002; 105(23): 2701 - 2703. [Full Text] [PDF]

				D. De Wolf, L. Foubert, Y. Van Belleghem, K. Mareels, D. Matthys, H. Verhaaren, and G. Van Nooten The influence of low afterload on the nature of the stress-velocity relationship J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1219 - 1225. [Abstract] [Full Text] [PDF]