What question did this study set out to answer?

This study aims to evaluate the effects of alterations in filling and contractility on indices of left ventricular mechanical performance in patients undergoing catheterization.

March 1, 1990The Journal of PhysiologyOpen Access

Responses to changes in filling and contractility of indices of human left ventricular mechanical performance.

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Why the study?

How do changes in filling and contractility affect indices of human left ventricular mechanical performance?

Key Points

This study aims to evaluate the effects of alterations in filling and contractility on indices of left ventricular mechanical performance in patients undergoing catheterization.
Analyzed indices of contractility using pacing with beta-adrenergic blockade in eight patients during left heart catheterization.
Employed catheter-tip manometer in the left ventricle and electromagnetic velocity transducer in the ascending aorta for measurements.
Investigated filling effects through head-up to head-down tilt and assessed inotropic effects with paced post-extrasystolic potentiation.
Filling through tilt increased left ventricular end-diastolic pressure by 8.1 mmHg (P<0.05), with stroke volume rising by 17.5% (P<0.05).
Post-extrasystolic potentiation led to a 35% rise in dPLV/dtmax (P<0.05) and a 55% increase in MA (P<0.05).
No difference in response was noted between patients with normal and impaired left ventricular ejection fraction.

Structured PICO

How do changes in filling and contractility affect indices of human left ventricular mechanical performance?

Population

8 patients undergoing routine left heart catheterization, including patients with normal and impaired left ventricular ejection fraction.

Intervention

Head-up to head-down tilt (to assess filling effects) and paced post-extrasystolic potentiation (to assess inotropic effects) during beta-adrenergic blockade.

Comparator

Baseline measurements prior to tilt or post-extrasystolic potentiation.

Outcome

Changes in left ventricular end-diastolic pressure (PLVED), maximum rate of rise of left ventricular pressure (dPLV/dtmax), peak velocity (PV), maximum acceleration (MA), and stroke volume (SV).surrogate

dPLV/dtmax is a volume-insensitive index of contractility in the intact human that responds markedly to inotropic changes but not to changes in filling, regardless of baseline ejection fraction.

Discussion

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Implication

dPLV/dtmax may aid contractility assessment during catheterization regardless of filling or EF; leaves open broader validation and clinical adoption.

Cite This Study

Drake‐Holland et al. (1990) studied this question.

synapsesocial.com/papers/6a70d6b722b3175134db58ac https://doi.org/10.1113/jphysiol.1990.sp017970

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Implication

dPLV/dtmax may aid contractility assessment during catheterization regardless of filling or EF; leaves open broader validation and clinical adoption.

Responses to changes in filling and contractility of indices of human left ventricular mechanical performance.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Responses to changes in filling and contractility of indices of human left ventricular mechanical performance.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider