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Am J Physiol Heart Circ Physiol 284: H2295-H2301, 2003. First published March 13, 2003; doi:10.1152/ajpheart.01110.2002
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Vol. 284, Issue 6, H2295-H2301, June 2003

Determinants of left ventricular preload-adjusted maximal power

Patrick Segers1, Vincent Tchana-Sato2, H. Alex Leather3, Bernard Lambermont2, Alexandre Ghuysen2, Jean-Michel Dogne2, Patricia Benoit2, Philippe Morimont2, Patrick F. Wouters3, Pascal Verdonck1, and Philippe Kolh2

1 Hydraulics Laboratory, Institute Biomedical Technology, Ghent University, 9000 Gent; 2 Hemodynamic Research Center, University of Liege, 4000 Liege; and 3 Centre for Experimental Surgery and Anaesthesiology, Katholieke Universiteit Leuven, 3000 Leuven, Belgium

Maximal left ventricular (LV) hydraulic power output (PWRmax), corrected for preload as PWRmax/(Ved)beta (where Ved is the end-diastolic volume and beta  is a constant coefficient), is an index of LV contractility. Whereas preload-adjusted maximal power (PAMP) is usually calculated with beta  = 2, there is uncertainty about the optimal value of beta  (beta  = 1 for the normal LV and 2 for the dilated LV). The aim of this work is to study the determining factors of beta . The data set consisted of 245 recordings (steady state and vena cava occlusion) in 10 animals in an ischemic heart pig model. The occlusion data yielded the slope (Ees; 2.01 ± 0.77 mmHg/ml, range 0.71-4.16 mmHg/ml) and intercept (V0; -11.9 ± 22.6 ml; range -76 to 39 ml) of the end-systolic pressure-volume relation, and the optimal beta -factor (assessed by fitting an exponential curve through the Ved-PWRmax relation) was 1.94 ± 0.88 (range 0.29-4.73). The relation of beta  with Ved was weak [beta  = 0.60 + 0.02(Ved); r2 = 0.20]. In contrast, we found an excellent exponential relation between V0 and beta  [beta  = 2.16<IT>e</IT><SUP>0.0189(V<SUB>0</SUB>)</SUP>, r2 = 0.70]. PAMP, calculated from the steady-state data, was 0.64 ± 0.40 mW/ml2 (range 0.14-2.83 mW/ml2) with a poor correlation with Ees (r = 0.30, P < 0.001). An alternative formulation of PAMP as PWRmax/(Ved - V0)2, incorporating V0, yielded 0.47 ± 0.26 mW/ml2 (range 0.09-1.42 mW/ml2) and was highly correlated with Ees (r = 0.89, P < 0.001). In conclusion, correct preload adjustment of maximal LV power requires incorporation of V0 and thus of data measured under altered loading conditions.

hemodynamics; ventricular function; blood flow; blood pressure; contractile function


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