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Whatever Happened to Measuring Ventricular Contractility in Heart Failure?
1Department of Medicine and Therapeutics, University of Aberdeen,Aberdeen, UK.
Cardiac Failure Review
|February 2, 2018
Summary
Measuring heart muscle contractility to identify heart failure is complex. End-systolic pressure-volume (ESPV) offers a more accurate index for assessing contractility changes, even during conditions like atrial fibrillation (AF).
Area of Science:
- Cardiology
- Physiology
Background:
- Assessing ventricular contractility is crucial for identifying heart failure.
- Early models of muscle contractility proved inadequate for accurate measurement.
Purpose of the Study:
- To review the challenges in measuring myocardial contractility.
- To explore the utility of end-systolic pressure-volume (ESPV) as an index of contractility.
- To discuss whether impaired contractility contributes to global heart failure.
Main Methods:
- Review of historical and current methods for assessing ventricular contractility.
- Discussion of the application of end-systolic pressure-volume (ESPV) relationships.
- Analysis of contractility changes during conditions such as atrial fibrillation (AF).
Main Results:
- End-systolic pressure-volume (ESPV) is considered a more accurate index of contractility.
- ESPV analysis can detect beat-to-beat variations in contractility, as observed during AF.
- Previous methods faced limitations in comparing contractility between individuals or identifying heart failure.
Conclusions:
- Accurate measurement of myocardial contractility remains challenging due to factors like fibre orientation and hypertrophy.
- End-systolic pressure-volume (ESPV) provides a valuable tool for assessing contractility.
- Further research is needed to determine if contractility failure is a primary driver of global heart failure.
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