(Circulation. 2000;102:1983.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
Single-Beat Estimation of End-Systolic Elastance Using Bilinearly Approximated Time-Varying Elastance Curve
From the Department of Cardiovascular Dynamics, National Cardiovascular Center Research Institute, Osaka (T. Shishido, T. Sato, M.S., K. Sunagawa), and Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto (K.H., K. Shigemi), Japan.
Correspondence to Toshiaki Shishido, MD, PhD, Department of Cardiovascular Dynamics, National Cardiovascular Center Research Institute, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. E-mail tosjoe{at}res.ncvc.go.jp
Background—Although left ventricular end-systolic elastance (Ees) has often been used as an index of contractility, technical difficulties in measuring volume and in changing loading conditions have made its clinical application somewhat limited. By approximating the time-varying elastance curve by 2 linear functions (isovolumic contraction phase and ejection phase) and estimating the slope ratio of these, we developed a method to estimate Ees on a single-beat basis from pressure values, systolic time intervals, and stroke volume.
Methods and Results—In 11 anesthetized dogs, we compared single-beat Ees with that obtained with caval occlusion. Although the decrease (but not the increase) in contractility (5.3 to 11.4 mm Hg/mL) and the change in loading conditions (3.7 to 34.0 mm Hg/mL) over wide ranges significantly altered the slope ratio, the estimation of Ees was reasonably accurate (y=0.97x+0.46, r=0.929, SEE=2.1 mm Hg/mL).
Conclusions—Ees can be estimated on a single-beat basis from easily obtainable variables by approximating the time-varying elastance curve by a bilinear function.
Key Words: contractility • elasticity • systole • ventricles • hemodynamics
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