Assessment of left ventricular function using a conductance catheter in the human heart
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M Takeuchi1, H Takaoka, M Odake
1First Department of Internal Medicine, Kobe University School of Medicine, Japan.
Insights
The conductance catheter accurately measures left ventricular (LV) volumes in patients. This tool also helps assess LV pressure-volume relations and contractile efficiency in clinical settings.
Area of Science:
- Cardiology
- Biomedical Engineering
- Physiology
Background:
- Accurate measurement of left ventricular (LV) volumes is crucial for diagnosing and managing heart disease.
- The conductance catheter is a potential tool for in-vivo hemodynamic assessment, but its clinical utility requires validation.
Purpose of the Study:
- To validate the clinical usefulness of the conductance catheter for measuring human LV volumes.
- To assess the conductance catheter's ability to evaluate LV pressure-volume relations and contractile efficiency.
Main Methods:
- Compared LV volumes measured by conductance catheter with biplane angiography in 19 heart disease patients.
- Analyzed end-systolic pressure-volume relation (ESPVR) and preload recruitable stroke work (PRSW) in 60 patients.
- Evaluated myocardial oxygen consumption (VO2)-pressure volume area (PVA) relation in 22 patients to assess contractile efficiency.
Main Results:
- Conductance catheter-derived LV volumes showed high correlation with angiographic volumes (r=0.94).
- ESPVR and PRSW relations were linear, with PRSW demonstrating greater linearity as a contractile index.
- The VO2-PVA relation indicated approximately 40% contractile efficiency in the control state.
Conclusions:
- The conductance catheter provides accurate LV volume measurements in a clinical setting.
- It facilitates reliable assessment of ESPVR, PRSW, and myocardial contractile efficiency in human hearts.
Abstract:
To validate the usefulness of the conductance catheter in the clinical setting, we first studied the accuracy of human left ventricular (LV) volume measured by conductance catheter in comparison with LV volume measured by biplane angiography in 19 patients with heart disease. Secondly, we made a comparison of end-systolic pressure volume relation (ESPVR) and preload recruitable stroke work (PRSW) relation in 60 patients with heart disease. Thirdly, we studied the myocardial oxygen consumption (VO2)-pressure volume area (PVA) relation to assess contractile efficiency in 22 patients with heart disease. There was a good correlation between the corrected conductance volume (Vcc) and the angiographic volume (V angio) (Vcc = 0.94 Vangio + 5.4, r = 0.94, P less than 0.001). Two relations, ESPVR and PRSW, were well described by straight lines with high correlation coefficients. However, PRSW was a more linear contractile index than ESPVR. The reciprocal of the slope of the VO2-PVA relation was approximately 40% in the control contractile state. We conclude that the conductance catheter accurately measures LV volumes and facilitates the assessment of ESPVR, PRSW and contractile efficiency in human LV.