Circulation, Vol 73, 586-595, Copyright © 1986 by American Heart Association
DA Kass, T Yamazaki, D Burkhoff, WL Maughan and K Sagawa
Using a multielectrode conductance catheter to estimate continuous left
ventricular volume we determined the end-systolic pressure-volume
relationship (ESPVR) in situ in open-chest anesthetized dogs. Dogs (n = 8)
were studied in the control state and after pharmacologic sympathectomy
(hexamethonium) and surgical vagotomy both before and after the
administration of dobutamine. ESPVR was measured during brief (5 to 6 sec)
preload reduction by balloon occlusion of the inferior vena cava (IVCBO).
The relationship was highly reproducible. The slope (Ecs) and volume
intercept (Vo) (mean +/- SD) in the control series were 5.8 +/- 3.6 mm
Hg/ml and 6.5 +/- 12.5 ml, respectively. Upon release of the IVCBO (preload
recovery), Ecs was 7.7 +/- 3.6 mm Hg/ml and Vo was 12.4 +/- 9.6 ml (p less
than .01). Autonomic blockade produced a 50% reduction in Ecs and a
concomitant decrease in Vo (p less than .01), and eliminated the difference
between ESPVR generated by preload reduction (IVCBO) and preload recovery
(IVCBO release). Subsequent dobutamine infusion increased Ecs to 6.1 +/-
3.5 mm Hg/ml and Vo to 4.1 +/- 6.9 ml, consistent with reported changes of
the ESPVR with positive inotropic intervention. A small artifact of right
ventricular filling was observed in the left ventricular volume catheter
signal, but this did not appreciably alter the ESPVR. These results
demonstrate the feasibility of the determination of ESPVR in situ by the
conductance catheter and brief IVCBO and underline the importance of the
use of rapid load changes to minimize reflex activation during the
measurements.
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Determination of left ventricular end-systolic pressure-volume relationships by the conductance (volume) catheter technique
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