Circulation, Vol 56, 845-852, Copyright © 1977 by American Heart Association
W Grossman, E Braunwald, T Mann, LP McLaurin and LH Green
End-systolic pressure (PES), volume (VES), wall tension (TES) and
circumference (CES) of the human left ventricle were studied at cardiac
catheterization in 24 subjects with varying degrees of left ventricular
dysfunction. Acute alterations in systolic load consistently resulted in
changes in VES and CES, with a smaller volume and circumference
characterizing the lower systolic load in each subject. End systolic
pressure-volume lines were constructed by plotting PES against VES at the
higher and lower systolic load in each subject. The slope of the resultant
lines was considerably steeper for normal than for poorly contractile left
ventricles. Vo, the volume axis intercept of the line (i.e., the
theoretical VES at PES = O) was significantly smaller for normal than for
poorly contractile ventricles. Similar findings were noted for Co, the
theoretic end-systolic circumference at zero end- systolic ventricular wall
tension. Post-extrasystolic potentiation resulted in decreased VES and CES
with no change in PES and only a slight fall in TES. In conclusion,
end-systolic pressure-volume and tension-circumference relations reflect
the contractile state of left ventricular myocardium. Quantitation of these
relationships may provide a useful new approach to the assessment of
myocardial function in man.
ARTICLES
Contractile state of the left ventricle in man as evaluated from end- systolic pressure-volume relations
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