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Cardiac Response to β-Adrenergic Stimulation Determined by Pressure-Volume Loop Analysis

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Non-invasive pressure-volume loop analysis in left ventricular load manipulation.

Karin Pola¹, Charlotte Burup Kristensen^2,3, William D Watson^4,5

¹Department of Clinical Sciences, Lund, Clinical Physiology, Skåne University Hospital Lund, Lund University, Lund, Sweden.

Clinical Physiology and Functional Imaging

|July 13, 2026

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Non-invasive cardiovascular magnetic resonance (CMR) derived pressure-volume (PV) loops effectively assess cardiac function under altered loading conditions in healthy individuals and hypertrophic cardiomyopathy (HCM) patients. This method aids in understanding cardiac response to interventions affecting preload and afterload.

Area of Science:

Cardiology
Cardiovascular Imaging
Biomedical Engineering

Background:

Clinical monitoring of heart failure and cardiomyopathy relies on assessing cardiac loading conditions.
Alterations in preload and afterload can reveal pathology via ventricular pressure-volume (PV) relations.

Purpose of the Study:

To assess non-invasive PV loops during left ventricular load manipulation.
To compare responses in healthy participants and patients with hypertrophic cardiomyopathy (HCM).

Main Methods:

46 participants (24 controls, 14 HCM patients, 8 volunteers) underwent paired experiments.
Load manipulation included intravenous saline or glyceryl trinitrate (GTN) infusion.
Non-invasive PV loops were calculated using cardiovascular magnetic resonance (CMR) and brachial blood pressure.

Keywords:

afterload contractility hemodynamic monitoring preload stroke work ventricular efficiency ventricular‐arterial coupling

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Main Results:

Saline increased end-diastolic volume and decreased end-systolic volume in controls, but not HCM.
Controls showed decreased arterial elastance and potential energy with saline; HCM did not.
Both groups had decreased ventricular-arterial coupling (VAC), increased ventricular efficiency and cardiac output with saline.
GTN infusion decreased ventricular volumes, but arterial elastance, VAC, efficiency, and cardiac output remained unchanged.

Conclusions:

Non-invasive PV analysis from CMR accurately detects cardiac response to altered loading conditions.
The findings support using CMR-derived PV loops for assessing cardiac thermodynamic performance.
This technique is valuable for evaluating interventions affecting preload and afterload.