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Inuzuka R, Kass DA, Senzaki H. Novel, single-beat approach for determining both end-systolic pressure-dimension relationship and preload recruitable stroke work. Open Heart. 2016;3(1):e000451doi: 10.1136/openhrt-2016-000451.
Inuzuka, R., Kass, D. A., & Senzaki, H. (2016). Novel, single-beat approach for determining both end-systolic pressure-dimension relationship and preload recruitable stroke work. Open heart, 3(1), e000451. https://doi.org/10.1136/openhrt-2016-000451
Inuzuka, Ryo, et al. "Novel, single-beat approach for determining both end-systolic pressure-dimension relationship and preload recruitable stroke work." Open heart vol. 3,1 (2016): e000451. doi: https://doi.org/10.1136/openhrt-2016-000451
Inuzuka R, Kass DA, Senzaki H. Novel, single-beat approach for determining both end-systolic pressure-dimension relationship and preload recruitable stroke work. Open Heart. 2016 Jun 15;3(1):e000451. doi: 10.1136/openhrt-2016-000451. eCollection 2016. PMID: 27347424; PMCID: PMC4916631.
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Open Heart. 2016 Jun 15;3(1):e000451. doi: 10.1136/openhrt-2016-000451. eCollection 2016.

Novel, single-beat approach for determining both end-systolic pressure-dimension relationship and preload recruitable stroke work.

Open heart

Ryo Inuzuka, David A Kass, Hideaki Senzaki

Affiliations

  1. Department of Pediatrics , University of Tokyo , Tokyo , Japan.
  2. Department of Cardiology , Johns Hopkins Medical Institution , Baltimore, Maryland , USA.
  3. Department of Pediatric Cardiology , Saitama Medical Center, Saitama Medical University , Kawagoe , Japan.

PMID: 27347424 PMCID: PMC4916631 DOI: 10.1136/openhrt-2016-000451

Abstract

OBJECTIVE: The end-systolic pressure-dimension relationship (ESPDR) and the preload recruitable stroke work (PRSW) relationship are load-insensitive measures of contractility, but their clinical application has been limited by the need to record multiple beats over a wide volume range. In this study, we therefore sought to validate a new method to concomitantly determine the ESPDR and the PRSW relationship from a single beat.

METHODS: Pressure-dimension loops were recorded in 14 conscious dogs under various haemodynamic and pathological conditions. Multiple-beat PRSW relationship was determined for its slope (Mw) and for a dimension-axis intercept (Dw). The ESPDR represented by the formula [Formula: see text], was estimated from a steady-state, single-beat late-systolic pressure-dimension relationship. The single-beat Mw was determined as an end-systolic pressure when the end-systolic dimension was equal to Dw.

RESULTS: A strong correlation was observed between multiple-beat and single-beat ESPDRs (zero-stress dimension; r=0.98, p<0.0001). The single-beat estimation of Mw calculated using the wall thickness was strongly correlated with the actual Mw (r=0.93, p<0.0001) and was sensitive enough to detect the change in contractility by dobutamine infusion (p<0.001) and by tachycardia-induced heart failure (p<0.001). Similar results were obtained for Mw estimated without information on wall thickness.

CONCLUSIONS: Mw can be interpreted as an end-systolic pressure when the end-systolic dimension is equal to Dw. By using the non-linear ESPDR, accurate single-beat estimation of the ESPDR and Mw is possible even without information on wall thickness. These results should enhance the applicability of pressure-volume framework to clinical medicine.

Keywords: CARDIAC FUNCTION; CONTRACTILITY; HEART FAILURE

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