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Determination of preload-recruitable stroke work and elastance by the relationship of arterial blood flow velocity to left ventricular area.

Abstract：

OBJECTIVE:The authors investigated the feasibility of an online sampling and display of LV flow-area loops for the determination of LV elastance and preload-recruitable stroke work (PRSW). Automated LV area measurements by echocardiography may be combined with flow velocity measurements in the internal carotid artery to construct LV flow-area loops as estimates of the systolic pressure-volume relationship. SETTING:University hospital. DESIGN:Open chest model. PARTICIPANTS:Eight anesthetized minipigs. INTERVENTIONS:Inferior vena cava occlusion was performed to simultaneously obtain parameters of the LV flow-area relationship and the LV pressure-area relationship. MEASUREMENTS AND MAIN RESULTS:Parameters were obtained at baseline and during sequential administration of dobutamine (5 microg/kg/min) and halothane (0.8 vol%). Linear regression analysis and analysis of variance were performed to investigate an underlying linear relationship between the corresponding variables. Highly linear elastance and PRSW curves were derived from the flow-area and pressure-area loops (n = 24, R >/= 0.85). Changes of the curve slopes indicated inotropic changes as well as model independent dP/dt(max). Elastance from the pressure-area relationship was expressed by elastance from the flow-area relationship by the term y = 0.52 + 0.04. x (R(2) = 0.84; p < 0.0001). Linear regression of PRSW as derived from the flow-area relationship with PRSW as derived from the pressure-area relationship was expressed by y = 0.43 + 0.02. x (R(2) = 0.77; p < 0.0001). CONCLUSION:Indices of the LV pressure-area relationship can be derived from real-time loops constructed from arterial flow velocity and LV area.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Broscheit JA,Greim CA,Kessler M,Weidemann F,Roewer N

doi

10.1053/j.jvca.2004.05.017

keywords:

subject

Has Abstract

pub_date

2004-08-01 00:00:00

pages

415-22

issue

eissn

1053-0770

issn

1532-8422

pii

S1053077004001168

journal_volume

pub_type

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Determination of preload-recruitable stroke work and elastance by the relationship of arterial blood flow velocity to left ventricular area.