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Rapid estimation of left ventricular contractility from end-systolic relations by echocardiographic automated border detection and femoral arterial pressure

Gorcsan, J and Denault, A and Gasior, TA and Mandarino, WA and Kancel, MJ and Deneault, LG and Hattler, BG and Pinsky, MR (1994) Rapid estimation of left ventricular contractility from end-systolic relations by echocardiographic automated border detection and femoral arterial pressure. Anesthesiology, 81 (3). 553 - 562. ISSN 0003-3022

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Abstract

Background: Automated echocardiographic measures of left ventricular (LV) cavity area are closely correlated with changes in volume and can be coupled with LV pressure to construct pressure-area loops in real time. The objective was to rapidly estimate LV contractility from the end-systolic relations of cavity area (as a surrogate for LV volume) and femoral arterial pressure (as a surrogate for LV pressure) in patients undergoing cardiac surgery. Methods: Studies were attempted on 18 consecutive patients with recordings of LV pressure, LV area, and femoral arterial pressure on a computer workstation interfaced with the ultrasound system. End-systolic pressure-area relations (in terms of pressure-area elastance [E'(es)]) from pressure-area loops during inferior vena caval occlusions were determined before and immediately after cardiopulmonary bypass using both LV and arterial pressure by semiautomated and automated iterative linear regression methods. Results: Data sets were available for 13 patients before and 8 patients after bypass (21 studies in 14 patients). E'(es) by arterial pressure was closely correlated with E'(es) by LV pressure: r = 0.96, standard error of the estimate = 2 mmHg/cm2, y = 1.01 x -0.7 by the semiautomated method and r = 0.94, standard error of the estimate = 3 mmHg/cm2, y = 1.02 x -0.5 by the automated method. Analysis of semiautomated and automated estimates of E'(es) from arterial pressure and E'(es) using LV pressure by the Bland-Altman method showed no systematic measurement bias and calculated limits of agreement of 8 and 9 mmHg/cm2, respectively. Similar decreases in E'(es) by arterial and LV pressure occurred from before to after bypass in 7 patients with paired data sets: 32 ± 12 to 15 ± 6 mmHg/cm2 and 32 ± 15 to 15 ± 7 mmHg/cm2, respectively (P < 0.05 for both). Conclusions: On-line femoral arterial pressure and LV area data by echocardiographic automated border detection may be used to rapidly calculate E'(es) as a means to estimate LV contractility in selected patients.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Gorcsan, Jgorcsan@pitt.eduGORCSAN
Denault, A
Gasior, TA
Mandarino, WA
Kancel, MJ
Deneault, LG
Hattler, BG
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 25 October 1994
Date Type: Publication
Journal or Publication Title: Anesthesiology
Volume: 81
Number: 3
Page Range: 553 - 562
DOI or Unique Handle: 10.1097/00000542-199409000-00006
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0003-3022
PubMed ID: 8092499
Date Deposited: 05 Mar 2012 17:09
Last Modified: 30 Jan 2020 16:55
URI: http://d-scholarship.pitt.edu/id/eprint/11171

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