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Am J Physiol Heart Circ Physiol 284: H744-H750, 2003. First published October 31, 2002; doi:10.1152/ajpheart.00455.2002
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Vol. 284, Issue 2, H744-H750, February 2003

Estimation of preload recruitable stroke work relationship by a single-beat technique in humans

Wen-Shin Lee1, Wen-Pin Huang2, Wen-Chung Yu1, Kuan-Rau Chiou3, Philip Yu-An Ding1, and Chen-Huan Chen1

1 Division of Cardiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei 112; 2 Division of Cardiology, Cheng Hsin Rehabilitation Medical Center, Taipei 112; and 3 Division of Cardiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, Republic of China

The slope of the preload recruitable stroke work relationship (Mw) is a highly linear, load-insensitive contractile index. To investigate whether Mw can be determined from a single steady-state beat, 45 patients were studied during cardiac catheterization. Single-beat Mw (SBMw) was calculated directly from the baseline stroke work and baseline left ventricular (LV) end-diastolic volume (EDVB), and the volume-axis intercept (Vw) was estimated as k × EDVB + (k - 1) × LVwall, where k is the ratio of the epicardial shell volumes corresponding to Vw and EDVB and LVwall is the wall volume. The mean of individual k values was 0.72 ± 0.04, which correlated with LV mass significantly (r = 0.60, P < 0.001). SBMw calculated from a constant k of 0.7 predicted Mw well (r = 0.88, P < 0.0001), and the prediction improved slightly when k was estimated from individual LV mass (r = 0.93, P < 0.0001). Subgroup analyses revealed that the single-beat technique also worked in patients with small or large LV mass or volume or with regional wall motion abnormalities. The absolute change in SBMw after dobutamine infusion also correlated with that in Mw. In conclusion, Mw can be estimated from a steady-state beat without alteration of preload.

hemodynamics; contractility; allometry


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