Comparative influence of load versus inotropic states on indexes of ventricular contractility: experimental and theoretical analysis based on pressure-volume relationships.
Key result
Alterations in end-diastolic volume and afterload resistance demonstrated a curvilinear relationship with ventricular contractility indexes in 23 canine ventricles.
Why the study?
How do load alterations and inotropic states influence indexes of ventricular contractility compared to the end-systolic pressure-volume relationship (ESPVR)?
Population
23 isolated supported canine ventricles
Comparison
Carefully controlled alterations in… vs Baseline or varying loading and inotropic states
Design
Preclinical
Authors
Discussion
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Implication
Load-sensitive indexes may detect inotropy better than ESPVR; leaves open translation from canine models to clinical use.
Structured PICO
How do load alterations and inotropic states influence indexes of ventricular contractility compared to the end-systolic pressure-volume relationship (ESPVR)?
P
Population
23 isolated supported canine ventricles
I
Intervention
Carefully controlled alterations in end-diastolic volume and afterload resistance, and inotropic stimulation
C
Comparator
Baseline or varying loading and inotropic states
O
Outcome
Influence of load change on ejection and isovolumetric phase indexes of left ventricular contractile function compared with sensitivity to inotropic stimulation and the end-systolic pressure-volume relationship (ESPVR)surrogate
While many clinical indexes of ventricular contractile function show significant load dependence, they often display greater sensitivity to inotropic change than the ESPVR, which derives its advantage from relative insensitivity to load alteration over a wider range.
Cite This Study
Kass et al. (1987) studied Ventricular contractility (n=23). Alterations in end-diastolic volume and afterload resistance vs. Inotropic stimulation was evaluated on Influence of load change on ejection and isovolumetric phase indexes of left ventricular contractile function. Alterations in end-diastolic volume and afterload resistance demonstrated a curvilinear relationship with ventricular contractility indexes in 23 canine ventricles.