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1 Institute of Biomedical Technology, Ghent University, Ghent, Belgium
2 Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
3 Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
4 Millar Instruments, Houston, Texas, USA
5 Laboratory of Hemodynamics and Cardiovascular Technology, Lausanne, Switzerland
6 Laboratory for Physiology, VU University Medical Center, Amsterdam, The Netherlands
* To whom correspondence should be addressed. E-mail: tom.claessens{at}ugent.be.
The linear time-varying elastance theory is frequently used to describe the change in ventricular stiffness during the cardiac cycle. The concept assumes that all isochrones (i.e. curves that connect pressure-volume data occurring at the same time) are linear and have a common volume intercept. Of specific interest is the steepest isochrone, the end-systolic pressure-volume relationship (ESPVR), of which the slope serves as an index for cardiac contractile function. Pressure-volume measurements achieved with a combined pressure-conductance catheter in the left ventricle of 13 open-chest anesthetized mice showed a marked curvilinearity of the isochrones. We therefore analyzed the shape of the isochrones using 6 regression algorithms (2 linear, 2 quadratic and 2 logarithmic, each with a fixed or time-varying intercept) and discussed the consequences for the elastance concept. Our main observations were: (i) the volume intercept varies considerably with time; (ii) isochrones are equally well described using quadratic or logarithmic regression; (iii) linear regression with a fixed intercept shows poor correlation (R2<0.75) during isovolumic relaxation and early filling, and (iv) logarithmic regression is superior in estimating the fixed volume intercept of the ESPVR. In conclusion, the linear time-varying elastance fails to provide a sufficiently robust model to account for changes in pressure and volume during the cardiac cycle in the mouse ventricle. A new framework accounting for the non-linear shape of the isochrones needs to be developed.
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