Circulation, Vol 73, 938-950, Copyright © 1986 by American Heart Association
T Aversano, WL Maughan, WC Hunter, D Kass and LC Becker
Dimension change measures of regional ventricular function, such as
absolute or percent wall thickening (delta T or % delta T) or segmental
shortening (delta L or % delta L), are highly load dependent. In 16
anesthetized mongrel dogs we assessed use of the end-systolic pressure-
thickness and end-systolic pressure-length relationships (ESPTR, ESPLR) as
more load-independent measures of regional function. We found that the
ESPTR and ESPLR could be measured without detectable baroreceptor- mediated
reflex changes in cardiac contractile state. Systemic administration of
dobutamine shifted the ESPTR to the right and the ESPLR to the left of
control, mainly due to a change in the slope (Ees) of the relationships.
Both delta T, % delta T and delta L, % delta L failed to detect the
positive inotropic effect of dobutamine because of an associated reduction
in preload. With systemic administration of propranolol, ESPTR, ESPLR,
delta T, % delta T, and delta L, % delta L detected the negative inotropic
effect. Thus systemic propranolol shifted the ESPTR to the left and the
ESPLR to the right of control, mainly due to a change in Ees. Regional
administration of dobutamine shifted the ESPTR and the ESPLR in the
direction of positive contractility in the region receiving the drug,
whereas simple dimension change measures of regional function failed to
detect the inotropic effect because preload fell and the timing of regional
end- systole was altered. With regional propranolol both the ESPTR, ESPLR
and simple dimension change measures detected the negative inotropic
effect. Thus the ESPTR, ESPLR is a reliable measure of regional ventricular
function and may be better than simple dimension change measures of
regional function, particularly when loading conditions or the timing of
regional systole is altered by an intervention.
ARTICLES
End-systolic measures of regional ventricular performance
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