Does a single-beat estimation method using bilinear approximation accurately measure left ventricular end-systolic elastance compared to caval occlusion in anesthetized dogs?
A novel single-beat method using bilinear approximation accurately estimates left ventricular end-systolic elastance without requiring changes in loading conditions.
Background —Although left ventricular end-systolic elastance (E es ) has often been used as an index of contractility, technical difficulties in measuring volume and in changing loading conditions have made its clinical application somewhat limited. By approximating the time-varying elastance curve by 2 linear functions (isovolumic contraction phase and ejection phase) and estimating the slope ratio of these, we developed a method to estimate E es on a single-beat basis from pressure values, systolic time intervals, and stroke volume. Methods and Results —In 11 anesthetized dogs, we compared single-beat E es with that obtained with caval occlusion. Although the decrease (but not the increase) in contractility (5.3 to 11.4 mm Hg/mL) and the change in loading conditions (3.7 to 34.0 mm Hg/mL) over wide ranges significantly altered the slope ratio, the estimation of E es was reasonably accurate ( y =0.97 x +0.46, r =0.929, SEE=2.1 mm Hg/mL). Conclusions —E es can be estimated on a single-beat basis from easily obtainable variables by approximating the time-varying elastance curve by a bilinear function.
Shishido et al. (Tue,) studied this question.