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Ventricular-load optimization by inotropic stimulation in patients with heart failure.

Abstract：

:To evaluate the effects of inotropic stimulation on ventriculo-arterial coupling, we determined both the slope of the end-systolic pressure-volume relationship (ventricular elastance) and the slope of end-systolic pressure-stroke volume relationship (arterial elastance) at rest and during dobutamine infusion (5 micrograms/kg/min). We also determined stroke work, end-systolic potential energy and the ventricular work efficiency defined as stroke work per pressure volume area (stroke work + potential energy). In the resting state, ventricular elastance was lower than arterial elastance and work efficiency was about 59.7 +/- 9.3% (mean +/- SD). This condition is remote from the point where stroke work or mechanical efficiency is optimal. Enhanced ventricular elastance by 41% with dobutamine resulted in a significant reduction in both left ventricular end-diastolic and end-systolic volumes and was accompanied by the reduction in arterial elastance by 23%. Consequently, the ratio of arterial elastance to ventricular elastance decreased from 1.43 +/- 0.57 to 0.82 +/- 0.47, which resulted in an increase in stroke work, a decrease in potential energy and hence a marked increase in work efficiency. Thus, inotropic stimulation of depressed hearts could modulate ventriculo-arterial coupling towards optimization of either stroke work or mechanical efficiency.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Ishizaka S,Asanoi H,Kameyama T,Sasayama S

doi

10.1016/0167-5273(91)90267-s

subject

Has Abstract

pub_date

1991-04-01 00:00:00

pages

51-8

issue

1

eissn

0167-5273

issn

1874-1754

pii

0167-5273(91)90267-S

journal_volume

31

pub_type

杂志文章

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