Right Ventricular Dysfunction During Endurance Exercise as Determined by Pressure-Volume Analysis

Figures

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  Figure 1. Schematic Overview of Single-Beat Modeling Technique for Determining Ees (Left) A sinusoid is fitted to the rising and falling isovolumic portions of the pressure waveform; the resulting peak of this sinusoid is known as the maximum isovolumic pressure. On the right, the line between maximum isovolumic pressure, at end-diastolic volume, and the end-diastolic pressure models the end-systolic pressure-volume relation, the slope of which is end-systolic elastance (EES). Effective arterial elastance is simply the slope of the line connecting end-diastolic pressure and no pressure (0) at end-diastolic volume.6 The occurrence of end systole (and in turn, end-diastolic pressure) may be measured directly, or it may be inferred from waveform features of the second time derivative of pressure.

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  Figure 2. Longitudinal Change in RV PV Analysis and Ventricular Structure and Function Derived From CMR (A) Longitudinal changes in the right ventricular (RV) pressure-volume (PV) analysis are shown. (B) Ventricular structure and function are derived from the cardiac magnetic resonance (CMR) data. avO2diff = peripheral oxygen extraction; EA = end-arterial elastance; EDV = end-diastolic volume; EES = end-systolic elastance; EF = ejection fraction; ESV = end-systolic volume; HR = heart rate; LV = left ventricle; PRSW = preload recruitable stroke work; SV = stroke volume; Vo2 = oxygen consumption.