Clinical evaluation of left heart function by conductance catheter technique

Methods to obtain pressure-volume loops in humans and their application to clinical diagnosis and treatment of cardiac disease are discussed. The method employs a conductance catheter, micromanometer, and inferior vena caval balloon occluder to reversibly and rapidly vary venous return. Multiple cardiac cycles measured during this manoeuvre are used to derive a variety of systolic and diastolic function indices, as well as estimates of vascular loading, and cardiac energetics. Strengths and weaknesses of the method as well as pressure-volume indexes themselves are briefly discussed. Lastly, three clinical examples are presented which serve to demonstrate how pressure-volume analysis can provide useful clinical information regarding diagnosis and/or treatment in subjects with heart failure symptoms.