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Related Experiment Videos

Left ventricular contractile function in aortic stenosis evaluated by isovolumic and ejection phase indexes

H H Brunner, U Steiger, N H Goebel

    American Heart Journal
    |February 1, 1977
    PubMed
    Summary

    For detecting abnormal left ventricular function in aortic stenosis, combining isovolumic and ejection phase indexes is most reliable. Neither index type alone is superior for assessing contractile function in this condition.

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    Wilhelm Martin Zinn (1916-2000).

    Rheumatology (Oxford, England)·2001

    Area of Science:

    • Cardiology
    • Biomedical Engineering
    • Physiology

    Background:

    • Assessing left ventricular (LV) contractile function is crucial in conditions like chronic pressure overload.
    • Aortic stenosis commonly causes chronic LV pressure overload, necessitating accurate functional assessment.
    • Existing methods rely on isovolumic and ejection phase indexes, but their comparative utility is debated.

    Purpose of the Study:

    • To reappraise the usefulness of isovolumic versus ejection phase indexes for detecting abnormal LV contractile function.
    • To evaluate index utility in patients with chronic LV pressure overload due to aortic stenosis.
    • To determine the most reliable method for assessing basal LV contractile function in this patient group.

    Main Methods:

    • Studied 41 patients with pure or predominant aortic stenosis.

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  • Measured LV pressure using micromanometry.
  • Acquired single-plane LV cineangiograms (RAO and A-P views).
  • Calculated isovolumic indexes: peak measured velocity of shortening of contractile elements (Vpm) and Vmax.
  • Calculated ejection phase indexes: mean velocity of circumferential fiber shortening (VCF) and mean normalized systolic ejection rate (MNSER).

    • Main Results:

    • Depressed Vpm in 39%, Vmax in 42%, VCF in 29%, and MNSER in 34% of patients.
    • Combined indexes identified abnormal function in 59% of patients.
    • Isovolumic and ejection phase indexes agreed in 65% (26/41) of patients.
    • Discordant results between index types were observed in 37% (15/41) of patients.
    • Left ventricular end-diastolic pressure showed inconsistent correlation with contractile function abnormalities.

    Conclusions:

    • Neither isovolumic nor ejection phase indexes are superior in sensitivity for assessing LV contractile function in chronic aortic stenosis.
    • Combining both isovolumic and ejection phase indexes offers the most reliable assessment of basal LV contractile function.
    • Accurate assessment of LV function in pressure overload requires a comprehensive approach using multiple index types.