Key result
Non-invasive quantification of pressure-volume loops using CMR detected dobutamine stress-induced increases in stroke work (1.3 to 1.7 J) and ventricular efficiency (71% to 82%) in healthy humans.
Why the study?
Non-invasive quantification of pressure-volume loops from brachial pressure and cardiovascular magnetic resonance was limited to resting heart rates.
Does an improved non-invasive method using CMR and brachial pressure accurately quantify pressure-volume loops at rest and during dobutamine stress?
Does an improved non-invasive method using CMR and brachial pressure accurately quantify pressure-volume loops at rest and during dobutamine stress?
An improved non-invasive method using CMR and brachial pressure can accurately quantify pressure-volume loops and ventricular-arterial coupling at rest and during dobutamine stress.
Supports non-invasive PV loop assessment during stress in healthy subjects; leaves open validation and translation to patients.
Non‐invasive quantification of pressure‐volume (PV) loops from brachial pressure and cardiovascular magnetic resonance is a validated method but its application has been limited to resting heart rates. The aim of this study was to improve the previous method and validate it against invasive left‐ventricular pressure measurements in an experimental porcine model, and further apply it to 16 healthy humans at rest and during dobutamine stress. In addition, the improved method calculates the arterial elastance which provides the computation of the ratio of effective arterial (E a ) to maximal ventricular elastance (E max ) representing the ventricular‐arterial coupling. In the porcine model, the differences between the improved non‐invasively derived PV loops and invasively measured PV loops were for stroke work (mean ± SD) 0.00 ± 0.03 J, ventricular efficiency −1.1 ± 0.4%, and contractility 1.1 ± 0.1 mmHg/ml. In human subjects during dobutamine stress, stroke work increased from 1.3 ± 0.3 to 1.7 ± 0.4 J, ventricular efficiency from 71 ± 4 to 82 ± 4%, contractility from 1.3 ± 0.2 to 2.3 ± 0.6 mmHg/ml, and the ratio of arterial to ventricular elastance decreased from 0.96 to 0.56. The improved method for non‐invasive PV loops constitutes a more robust diagnostic tool for cardiac disease states in a wider range of study cohorts at both rest and during stress.
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Sjöberg et al. (2021) studied Healthy (n=16). Non-invasive quantification of pressure-volume loops vs. Resting state and invasive measurements was evaluated on Hemodynamic parameters including stroke work, ventricular efficiency, and contractility. Non-invasive quantification of pressure-volume loops using CMR detected dobutamine stress-induced increases in stroke work (1.3 to 1.7 J) and ventricular efficiency (71% to 82%) in healthy humans.
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