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Related Experiment Videos

Assessment of left-ventricular function

E R Schertel1

  • 1Department of Surgery, College of Medicine, The Ohio State University, Columbus, USA.

The Thoracic and Cardiovascular Surgeon
|November 20, 1998
PubMed
Summary
This summary is machine-generated.

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Assessing left-ventricular function requires examining the cardiac cycle

Area of Science:

  • Cardiology
  • Physiology
  • Biomedical Engineering

Background:

  • Global left-ventricular function assessment relies on analyzing the cardiac cycle's three phases: contraction, active relaxation, and passive relaxation.
  • Accurate left-ventricular pressure and volume measurements are crucial for evaluating these cardiac cycle phases.
  • The ideal contractility index should be sensitive to inotropic state but insensitive to loading conditions, heart rate, and cardiac size.

Purpose of the Study:

  • To explore indices for assessing global left-ventricular function across the cardiac cycle's distinct phases.
  • To identify and discuss commonly employed and 'ideal' indices of cardiac contractility and relaxation.
  • To highlight the importance of understanding these indices for interpreting ventricular function in health and disease.

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Main Methods:

  • Examination of indices derived from the contraction phase, including isovolumic contraction, end-systolic pressure-volume relationship, ejection phase, and stress-strain relationship.
  • Assessment of active relaxation using the time constant (tau) of ventricular pressure decline during isovolumic relaxation.
  • Evaluation of passive relaxation and diastolic stiffness via the end-diastolic pressure-volume relationship.

Main Results:

  • Commonly used contractility indices include preload recruitable stroke work, dP/dt - end-diastolic volume relationship, and end-systolic elastance.
  • The time constant (tau) inversely reflects ventricular function and active relaxation, influenced by factors affecting contractility.
  • The end-diastolic pressure-volume relationship quantifies diastolic stiffness, influenced by cardiac viscoelasticity, pericardial constraint, and ventricular interaction.

Conclusions:

  • Understanding indices from all three cardiac cycle phases is vital for comprehensive left-ventricular function assessment.
  • Specific indices like preload recruitable stroke work, dP/dt - end-diastolic volume relationship, end-systolic elastance, and tau offer valuable insights.
  • Knowledge of these indices and their interactions aids in interpreting ventricular function in various physiological and pathological states.