Circulation, Vol 78, 736-745, Copyright © 1988 by American Heart Association
WC Little, CP Cheng, T Peterson and J Vinten-Johansen
We assessed the linearity and slope of the left ventricular end- systolic
pressure (PES)-volume (VES) relation over a wide range of contractile
states in conscious dogs. The animals were instrumented to determine left
ventricular volume from ultrasonic left ventricular internal dimensions and
measure left ventricular pressure with a micromanometer. Studies were
performed 1-2 weeks after instrumentation while the animals were conscious.
Contractile state was increased by incremental infusion of dobutamine (0,
2, 4, 6, and 8 micrograms/kg/min i.v.) and decreased by verapamil (10 mg
i.v.) given after autonomic blockade. The 44 +/- 11 mm Hg (mean +/- SD)
portion of the PES-VES relation generated by bicaval occlusion demonstrated
a slight but consistent nonlinearity, apparent as a concavity toward the
volume axis. This nonlinearity, present at all inotropic states, did not
prevent the PES-VES relation from being well approximated by a straight
line (r = 0.984 +/- 0.020, SEE = 2.1 +/- 1.4 mm Hg); furthermore, the slope
of the PES-VES line provided a sensitive index of contractile state,
progressively increasing with incremental doses of dobutamine and
decreasing in response to verapamil. The volume-axis intercept of the
linear approximation of the PES-VES relation was 2.9 +/- 3.3 ml less (p
less than 0.05) than the volume-axis intercept of the nonlinear quadratic
fit. Thus, the linear PES-VES relation, whose slope is sensitive to a wide
variety of inotropic states, is a reasonable and useful description of the
left ventricle in the range of PES-VES points that can be produced by
bicaval occlusion in the conscious dog. However, linear extrapolation of
the relation beyond the range of data points may not be accurate.
ARTICLES
Response of the left ventricular end-systolic pressure-volume relation in conscious dogs to a wide range of contractile states [published erratum appears in Circulation 1989 Jan;79(1):205]
Department of Medicine, Bowman-Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
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