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Modeling of asynchronous myocardial contraction by effective stroke volume analysis

Strum, DP and Pinsky, MR (2000) Modeling of asynchronous myocardial contraction by effective stroke volume analysis. Anesthesia and Analgesia, 90 (2). 243 - 251. ISSN 0003-2999

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Left ventricular (LV) regional wall motion abnormalities (RWMA) are not easily quantified. We describe a model for quantifying RWMA by referencing regional amplitude and phase angle changes to global LV systole in eight anesthetized, open-chest dogs. Regional and total LV volumes (conductance catheter), regional shortening (epicardial piezoelectric crystals), and LV pressure were measured before, during, and after transient esmolol-induced apical RWMA. Regional phase angle (α) was defined as the relative distance, measured in degrees, that regional minimal volume differs from global end- systole. We compared maximal stroke volume (SV) with effective SV (that portion of regional SV contributing to total LV SV). Regional effective SV was also calculated from our model as the product of cosine α and regional maximal SV. Esmolol delayed apical end-systolic α (14.3°± 11.4°versus 35.7°±8.0° baseline versus esmolol, P<0.05) and decreased apical effective SV (2.4±0.3 versus 1.7±0.3 mL, P<0.05), while apical maximal SV and total LV SV were not altered. Piezoelectric crystal dimension changes mirrored regional SV changes. We conclude that effective SV and phase angle analysis are more sensitive measures of regional myocardial dysfunction when RWMA exist than are measures of maximal regional SV. Implications: In a dog model of regional myocardial dyskinesis induced by esmolol, effective regional stroke volume and phase angle analyses are more sensitive measures of regional myocardial dysfunction than measures of maximal regional stroke volume that do not account for phase shifts.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Strum, DP
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 January 2000
Date Type: Publication
Journal or Publication Title: Anesthesia and Analgesia
Volume: 90
Number: 2
Page Range: 243 - 251
DOI or Unique Handle: 10.1097/00000539-200002000-00003
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0003-2999
PubMed ID: 10648302
Date Deposited: 22 Mar 2012 20:45
Last Modified: 20 Jul 2020 13:55


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