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Left ventricular performance assessed by echocardiographic automated border detection and arterial pressure.

Denault, AY and Gorcsan, J and Mandarino, WA and Kancel, MJ and Pinsky, MR (1997) Left ventricular performance assessed by echocardiographic automated border detection and arterial pressure. Am J Physiol, 272 (1 Pt 2). H138 - H147. ISSN 0002-9513

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Automated echocardiographic measures of left ventricular (LV) cavity area are closely correlated with changes in volume and can be coupled with LV pressure (PLV) to construct pressure-area loops in real time. The objective was to rapidly estimate LV contractility from end-systolic relationships of cavity area (as a surrogate for LV volume) and central arterial pressure (Pa) (as a surrogate for PLV) in a canine model using automated algorithms. In eight anesthetized mongrel dogs, we simultaneously measured PLV, LV area, and Pa (fluid-filled catheter). End-systolic pressure-area relationships in terms of pressure-area elastance (E'es)] from pressure-area loops during inferior vena caval occlusions were determined during basal conditions (control), dobutamine infusion (5-10, and after bolus propranolol (2 mg/kg) with both PLV and Pa by semiautomated and automated iterative regression methods. E'es increased during dobutamine infusion and decreased after propranolol infusion in all animals and with all iterative methods. Estimates of Ees from Pa were closely correlated with E'es from PLV by both the semiautomated and automated methods (r = 0.93; P < 0.01). The relationship between E'es obtained from Pn for the two methods was also closely correlated. Although the automated methods displayed larger differences from the semiautomated iterative technique by Bland-Altman analysis, the change in E'es with all techniques during dobutamine infusion and after propranolol infusion was of similar magnitude and direction among the three techniques. Greater variability with the dobutamine runs was partially due to abnormally conducted ventricular beats that minimized the number of consecutive beats that could be used for these analyses. We conclude that on-line Pa recordings from fluid-filled catheters can be used with echocardiographic automated border detection to rapidly calculate E'es as a means to estimate LV contractility.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Denault, AY
Gorcsan, J
Mandarino, WA
Kancel, MJ
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: January 1997
Date Type: Publication
Journal or Publication Title: Am J Physiol
Volume: 272
Number: 1 Pt 2
Page Range: H138 - H147
DOI or Unique Handle: 10.1152/ajpheart.1997.272.1.h138
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
Uncontrolled Keywords: Algorithms, Animals, Automation, Blood Pressure, Dobutamine, Dogs, Echocardiography, Elasticity, Ligation, Myocardial Contraction, Propranolol, Systole, Vena Cava, Inferior, Ventricular Function, Left
ISSN: 0002-9513
PubMed ID: 9038932
Date Deposited: 05 Mar 2012 19:58
Last Modified: 30 Jan 2020 16:55


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