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Articles in PresS, published online ahead of print January 3, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00638.2001
Submitted on July 23, 2001
Accepted on December 7, 2001
1 Department of Thoracic Surgery, University Hospital in Tromso, Tromso, Norway
* To whom correspondence should be addressed. E-mail: knutek{at}fagmed.uit.no.
The end-systolic pressure-volume relationship (ESPVR) is regarded as a useful index for assessing the contractile state of the heart. However, the need for preload alterations has been a serious limitation to its clinical applications, and there has been numerous attempts to develop a method for calculating contractility based on one, single pressure-volume loop. We have evaluated four of these methods. Pressure and volume data were obtained by combined pressure and conductance catheters in 37 pigs. All four methods were applied to 88 steady state pressure/volume files, including 8 files sampled during dopamine infusions. Estimates of single-beat contractility (elastance) were compared to preload-varied multiple-beat elastance (Ees(MB)). All methods had a low average bias (-0.3 to 0.5 mmHg/ml) but limits of agreement (±2SD) were unacceptably high (±2.6 to ±3.8 mmHg/ml). In the dopamine group Ees(MB) showed an increase of 1.7±0.8 mmHg/ml (mean±SD) compared to baseline (p<0.001). None of the single-beat methods predicted this increase in contractility. It's therefore doubtful if any of the methods allow for single-beat assessment of contractility.
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