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Assessment of left ventricular contractile state by preload-adjusted maximal power using echocardiographic automated border detection

Mandarino, WA and Pinsky, MR and Gorcsan, J (1998) Assessment of left ventricular contractile state by preload-adjusted maximal power using echocardiographic automated border detection. Journal of the American College of Cardiology, 31 (4). 861 - 868. ISSN 0735-1097

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Objectives. We sought to assess the ability of preload-adjusted maximal power measured by echocardiographic automated border detection (ABD) to quantify left ventricular (LV) contractility by determining the effects of alterations in preload, afterload and contractile state. Background. Preload- adjusted maximal power can reflect LV contractile state relatively independent of changes in loading conditions. Methods. Eight anesthetized dogs had placement of aortic electromagnetic flow probes, LV and arterial pressure catheters and inferior vena caval (IVC) occluders; four had placement of thoracic aortic balloon occluders. Echocardiographic ABD measures of cross-sectional area were used as a surrogate for LV volume, and flow was estimated as the first derivative of area with respect to time. Power was calculated as the product of flow and pressure. Results. Preload independence during vena caval occlusions was achieved by preload adjustment (/ [end-diastolic area](3/2)). Afterload independence was demonstrated by preload-adjusted maximal power being unaffected by acute increases in LV systolic pressure induced by aortic occlusion. ABD preload-adjusted maximal power reflected changes in contractile state: increasing with dobutamine infusion from 36 ± 14 to 70 ± 15 mW/cm4 (p < 0.05 vs. control) and decreasing with propranolol infusion from 35 ± 13 to 17 ± 7 mW/cm4 (p < 0.05 vs. control). These changes were significantly correlated with calculations of preload-adjusted maximal power using aortic flow (r = 0.90, SEE 10.5 mW/cm4) and load-independent measures of end-systolic elastance from pressure-area loops (r = 0.90, SEE 10.6 mW/cm4). Calculations of normalized preload-adjusted maximal power using arterial pressure were also closely correlated with similar calculations using LV pressure (r = 0.99, SEE 3%). Conclusions. Preload-adjusted mammal power using echocardiographic ABD can predict LV contractile state relatively independent of loading conditions and has potential for clinical application.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Mandarino, WA
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Gorcsan, Jgorcsan@pitt.eduGORCSAN
Date: 15 March 1998
Date Type: Publication
Journal or Publication Title: Journal of the American College of Cardiology
Volume: 31
Number: 4
Page Range: 861 - 868
DOI or Unique Handle: 10.1016/s0735-1097(98)00005-9
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0735-1097
PubMed ID: 9525560
Date Deposited: 13 Mar 2012 15:48
Last Modified: 22 Jun 2021 14:55


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