June 12, 2026Journal of the American College of Cardiology
Noninvasive single-beat determination of left ventricular end-systolic elastance in humans
Key result
Noninvasive single-beat estimation of LV end-systolic elastance strongly correlates with invasive measurements.
- r = 0.91
- P<0.00001
- n=50
Why the study?
Use of left ventricular end-systolic elastance in heart failure assessment and management was limited by the lack of a simple noninvasive measurement method.
Does a noninvasive single-beat method accurately estimate left ventricular end-systolic elastance compared to invasive measurement in patients with cardiovascular disorders?
Population
43 patients with varying cardiovascular disorders, plus 7 patients in a separate group
Comparison
Noninvasive single-beat E(es) vs invasively measured E(es)
Design
Blinded validation study
Authors
Discussion
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Member takes
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Left ventricular ejection fraction (EF) depends on ventricular contractility, afterload, and preload... The utility of PV loops and PV relationships to characterize and quantify the mechanical properties of the left ventricle was demonstrated by Otto Frank in 1895.”
“a major barrier to routine clinical implementation is that PV loop measurements have historically required invasive assessment of left ventricular pressures using catheterization... noninvasive imaging surrogates for invasive physiology and alternate methods for PV loop estimation are highly desirable”
Implication
May support noninvasive LV elastance assessment clinically; leaves open prospective validation before routine use.
Key Points
- The study aims to develop and validate a noninvasive method for estimating left ventricular end-systolic elastance in humans.
- Calculated left ventricular end-systolic elastance using noninvasive single-beat parameters.
- Used systolic and diastolic arm-cuff pressures, echo-Doppler stroke volume, and ejection fraction.
- Compared noninvasive estimates with invasive measurements in 43 patients with cardiovascular disorders.
- Baseline and dobutamine-stimulated E(es) ranged from 0.4 to 8.4 mm Hg/ml with a strong correlation to E(es(sb)): E(es) = 0.86 x E(es(sb)) + 0.40 (r = 0.91, p < 0.00001).
- Change in E(es(sb)) before and after dobutamine correlated well with invasive measures: DeltaE(es) = 0.86 x DeltaE(es(sb)) + 0.67 (r = 0.88, p < 0.00001).
- Repeated measures of E(es(sb)) demonstrated a coefficient of variation of 20.3 +/- 6% among seven patients.
Study Design
Type
Observational (n=50)
Blinding
Single-blind
Structured PICO
Does a noninvasive single-beat method accurately estimate left ventricular end-systolic elastance compared to invasive measurement in patients with cardiovascular disorders?
P
Population
50 patients with varying cardiovascular disorders evaluated to validate a noninvasive single-beat method for estimating left ventricular end-systolic elastance.
E
Exposure
Noninvasive single-beat determination of left ventricular end-systolic elastance (E(es(sb))) using arm-cuff pressures and echocardiography
C
Comparator
Invasively measured left ventricular end-systolic elastance (E(es))
O
Outcome
Correlation between noninvasive E(es(sb)) and invasive E(es)surrogate
Main Result
Effect estimate: r = 0.91
p-value: p=<0.00001
A novel noninvasive single-beat method using arm-cuff pressures and echocardiography can reliably estimate left ventricular end-systolic elastance, correlating strongly with invasive measurements.
Cite This Study
Chen et al. (2001) conducted an observational in Cardiovascular disorders (n=50). Noninvasive single-beat determination of left ventricular end-systolic elastance vs. Invasively measured left ventricular end-systolic elastance was evaluated on Correlation between noninvasive and invasive left ventricular end-systolic elastance (r = 0.91, p=<0.00001). Noninvasive single-beat estimation of left ventricular end-systolic elastance strongly correlated with invasively measured values (r = 0.91, p < 0.00001).