Circulation, Vol 79, 431-440, Copyright © 1989 by American Heart Association
JB Su and B Crozatier
End-systolic pressure-volume relations (ESPVRs) were analyzed in 10
closed-chest autonomically blocked dogs before and after volume loading
that restored end-diastolic volume to its value measured in the control
conscious state. Dogs had been previously instrumented with a left
ventricular pressure micromanometer and ultrasonic crystals for
measurements of major, anteroposterior, and septum-free wall diameters.
Left ventricular volume was calculated with an ellipsoidal model in the
left ventricular cavity. ESPVRs obtained during caval occlusion after
volume loading were curvilinear as shown by the division of the relation
into two parts. The initial part of the relation had a significantly
smaller ESPVR slope (Ees, 12.0 +/- 1.8 mm Hg/ml) and ESPVR volume-axis
intercept (Vd, - 3.5 +/- 0.8 ml) than the final part of the relation (19.5
+/- 3.1 mm Hg/ml and 0.0 +/- 0.6 ml, respectively, p less than 0.01). The
end-diastolic volume-peak dP/dt relation showed a similar curvilinearity
when end-diastolic volumes were larger than 1.5-1.7 times the minimal
end-diastolic volume reached during caval occlusion. ESPVRs were not
different during aortic constriction and caval occlusion when end-diastolic
volume was small. In contrast, with large end-diastolic volumes, Ees and Vd
were significantly smaller during caval occlusion than during aortic
constriction. The final part of ESPVR (with small end-diastolic volume) had
the same slope and intercept as that during aortic constriction. We
conclude that preload produces a curvilinearity of ESPVR that significantly
modifies derived indexes when the range of preload changes is large.
ARTICLES
Preload-induced curvilinearity of left ventricular end-systolic pressure-volume relations. Effects on derived indexes in closed-chest dogs
Institut National de la Sante et de la Recherche Medicale U2, Hopital Leon Bernard, Limeil-Brevannes, France.
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