Pressure-volume Relationship in the Stress-echocardiography Laboratory: Does (Left Ventricular End-diastolic) Size Matter?
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Date
2017-02-01
Authors
Bombardini, Tonino
Mulieri, Louis A.
Salvadori, Stefano
Costantino, Marco Fabio
Scali, Maria Chiara
Marzilli, Mario
Picano, Eugenio
Journal Title
Journal ISSN
Volume Title
Publisher
Revista Española de Cardiología (English Edition)
Abstract
Abstract Introduction and objectivesThe variation between rest and peak stress end-systolic pressure-volume relation is an afterload-independent index of left ventricular contractility. Whether and to what extent it depends on end-diastolic volume remains unclear. The aim of this study was to assess the dependence of the delta rest-stress end-systolic pressure-volume relation on end-diastolic volume in patients with negative stress echo and all ranges of resting left ventricular function. MethodsWe analyzed interpretable data obtained in 891 patients (593 men, age 63 ± 12 years) with ejection fraction 47% ± 12%: 338 were normal or near-normal or hypertensive; 229 patients had coronary artery disease; and 324 patients had ischemic or nonischemic dilated cardiomyopathy. They were studied with exercise (n = 172), dipyridamole (n = 482) or dobutamine (n = 237) stress echocardiography. The end-systolic pressure-volume relation was evaluated at rest and peak stress from raw measurement of systolic arterial pressure by cuff sphygmomanometer and end-systolic volume by biplane Simpson rule 2-dimensional echocardiography. ResultsAbsolute values of delta rest-stress end-systolic pressure-volume relation were higher for exercise and dobutamine than for dipyridamole. In the overall population, an inverse relationship between end-systolic pressure-volume relation and end-diastolic volume was present at rest (r2 = 0.69, P < .001) and peak stress (r2 = 0.56, P < .001), but was absent if the delta rest-stress end-systolic pressure-volume relation was considered (r2 = 0.13). ConclusionsLeft ventricular end-diastolic volume does not affect the rest-stress changes in end-systolic pressure-volume relation in either normal or abnormal left ventricles during physical or pharmacological stress.
Description
Keywords
Stress echocardiography, Physiology, Diastole, Contractility
Citation
Tonino Bombardini, Louis A. Mulieri, Stefano Salvadori, Marco Fabio Costantino, Maria Chiara Scali, Mario Marzilli, Eugenio Picano, Pressure-volume Relationship in the Stress-echocardiography Laboratory: Does (Left Ventricular End-diastolic) Size Matter?, In Revista Española de Cardiología (English Edition), Volume 70, Issue 2, 2017, Pages 96-104