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Related Experiment Videos

Preload-adjusted right ventricular maximal power: concept and validation.

Soren Schenk1, Zoran B Popović, Yoshie Ochiai

  • 1Dept. of Biomedical Engineering/ ND20, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

American Journal of Physiology. Heart and Circulatory Physiology
|May 25, 2004
PubMed
Summary
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Right ventricular maximal power (PWR(mx)) can be adjusted for preload dependency using a linear relationship with end-diastolic volume (EDV). This method provides a preload-independent estimate of right ventricular contractility, potentially enabling noninvasive assessment.

Area of Science:

  • Cardiovascular Physiology
  • Cardiac Mechanics
  • Hemodynamics

Background:

  • Right ventricular maximal power (PWR(mx)) is influenced by preload (filling pressure).
  • Existing methods for assessing cardiac contractility often require load independence.
  • The relationship between PWR(mx) and end-diastolic volume (EDV) has not been fully characterized for preload adjustment.

Purpose of the Study:

  • To test the hypothesis that the PWR(mx) versus EDV relationship is linear.
  • To determine if the x-axis intercept (V(0PWR)) of the PWR(mx) versus EDV relationship corresponds to the preload-recruitable stroke work (PRSW) intercept (V(0SW)).
  • To develop a method for preload adjustment of PWR(mx) to yield a load-independent index of right ventricular contractility.

Main Methods:

  • Instrumentation of ten dogs with pulmonary flow probes, micromanometers, and RV conductance catheters.

Related Experiment Videos

  • Acquisition of data during bicaval occlusions under varied conditions.
  • Fitting PWR(mx) versus EDV data to a power function and analyzing linearity and intercepts.

    • Main Results:

    • The PWR(mx) versus EDV relationship was found to be linear (beta ≈ 1, P > 0.05).
    • The PWR(mx) x-axis intercept (V(0PWR)) correlated strongly with the PRSW intercept (V(0SW)) (r = 0.93, P < 0.0001).
    • Preload adjustment of PWR(mx) using V(0PWR) or an estimated V(0PWR) (V(0Est)) resulted in a preload-independent index (PAMP(V0PWR) and PAMP(V0Est)) that correlated with PRSW and reflected changes in contractility.

    Conclusions:

    • A linear PWR(mx) versus EDV relationship exists, with a distinct intercept (V(0PWR)).
    • Preload adjustment of PWR(mx) using V(0PWR) or V(0Est) yields a preload-independent measure of right ventricular contractility.
    • This adjusted PWR(mx) (PAMP(V0PWR)) may serve as a noninvasive index of right ventricular contractility.