Key result
Early peak ejection flow minimizes LV external work compared to late peak flow.
Why the study?
Models of left-ventricular ejection based on optimal performance include external work in the optimality criterion, but the minimum external work criterion and its implications require analysis.
Theoretical modeling demonstrates that left ventricular ejection patterns with peak flow in the first half of ejection minimize external work, aligning with experimental observations.
Answers are grounded in this paper and cite their sources.
No immediate change to clinical ejection targets; leaves open validation of early-peak patterns in human HF.
This paper deals with models of left-ventricular ejection which are based on the hypothesis of optimal performance. The assumptions made in the models published so far are analyzed, and some major modeling difficulties are discussed. In most of the models, the term describing the external work done by the left ventricle during ejection is included in the optimality criterion. In this paper, the minimum external work criterion is analyzed by comparing the values of external work for different theoretical ejection patterns. The ejection patterns used in the comparisons must satisfy certain feasibility and normalization conditions. The results show that an ejection pattern with the peak flow in the first half of ejection, which resembles the experimental observations, is optimal with respect to minimizing the external work. An ejection pattern with the peak flow in the second half of ejection is the least efficient of the patterns studied.
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Hämäläinen et al. (1985) studied Left-ventricular ejection models. Theoretical ejection patterns vs. Different theoretical ejection patterns was evaluated on External work. An ejection pattern with peak flow in the first half of ejection is optimal for minimizing external work, whereas peak flow in the second half is the least efficient.
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