Mechanical determinants of transient changes in stroke volume

To better define beat-to-beat regulation of stroke volume (SV), the several-beat transient response of the left ventricle (LV) to sudden changes in hydraulic loading impedance was studied. Data were collected from eight canine isolated heart-lung preparations with controlled LV loading impedance. At a selected diastolic interval, a sudden increase in hydraulic loading resistance was induced. The resulting transient response in SV, end-diastolic pressure (EDP), and end-systolic pressure (ESP) was analyzed by comparing the relative predictive capability of six competing models, each incorporating different degrees of complexity in the relationship between SV and EDP and ESP. The basic model assumed linear LV pressure-volume relationships at both end diastole and end systole. Incorporation of nonlinear, end-state interaction or coronary perfusion pressure effects into the basic model did not improve predictive performance. Models incorporating SV and ESP of the preceding beat as well as ejecting beat ESP and EDP were consistently superior to all other models. The ranking of the relative influence of the determinants of SV was 1) ejecting beat ESP, 2) preceding beat ESP, 3) ejecting beat EDP, and 4) preceding beat SV.