Summary
The assessment of cardiac function by catheterization began with the application of Frank-Starling’s mechanism in clinical practice. Although numerous indexes of contractility have been proposed in the past 20 years, the most reliable methods currently used are: (1) Emax (the slope of end-systolic pressure volume line obtained by changing afterload) by means of pressure and volume recordings, (2) the force-length (end-systolic stress-end-systolic volume) relationship either in the two-dimensional framework or these ratio, and (3) the stress-shortening (afterload-shortening) relationship in the two-dimensional framework for the analysis of systolic function.
Left ventricular relaxation is usually assessed by obtaining the time constant of the pressure fall during the isovolumic relaxation period. The assessment of chamber compliance can be obtained by analysis of the diastolic pressure-volume relationship, and that of muscle compliance can be done by analysis of the stress-strain relationship.
For these evaluations of systolic and diastolic function, the accurate measurement of pressure, volume, and wall thickness are mandatory. Every index proposed in the past, and in current use, has theoritical as well as methodological limitations; there is no golden standard for the assessment of cardiac function.
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References
Sarnoff SJ, Berglund E (1954) Ventricular function. I. Starling’s law of the heart studied by means of simultaneous right and left ventricular function curve in the dog. Circulation 9: 706–718
Braunwald E, Ross J Jr (1979) Control of cardiac performance. In: Berne RM (ed): Cardiovascular system. American Physiological Society, Bethesda, Maryland, pp 533–580 (Handbook of physiology, vol 1/2)
Tyberg JV (1989) Ventricular interaction and the pericardium. In: Levine HJ, Gaasch WH (eds) The ventricle. Basic and clinical aspects. Martinus Nijhoff, Boston, pp 171–207
Milnor, MR (1975) Arterial impedance as ventricular afterload. Circ Res 36: 565–570
Hirota Y, Suwa M, Takatsu T (1978) Mid-systolic endocardial stress as a noninvasive index of afterload. J Cardiogr 8: 99–106
Reicheck N, Wilson J, St John Sutton M, Plappert TA, Goldberg S, Hirshfeld JW (1982) Noninvasive determination of left ventricular end-systolic stress: Variation of the method and initial application. Circulation 65: 99–108
Weiss JL, Frederiksen JW, Weisfeldt ML (1976) Hemodynamic determinants of the time-course of fall in canine left ventricular pressure. J Clin Invest 58: 751–760
Hori M, Inoue M, Kitakaze M, Tsujioka K, Ishida Y, Fukunami M, Nakajima S, Kitabatake A, Abe H (1984) Ejection timing as a major determinant of left ventricular ralaxation rate in isolated perfused canine heart. Circ Res 55: 31–38
Kumada T, Takayama K, Matsuzaki M, Matsuda Y, Kusukawa R (1982) Assessment of left ventricular relaxation in the diseased heart in man. Jpn Circ J 46: 58–63
Diamond G, Forrester JS, Hergis J, Parmley WW, Danzig R, Swan HJC (1971) Diastolic pressure-volume relationship in the canine left ventricle. Circ Res 29: 267–275.
Gaasch WH, Apstein CS, Levine HJ (1985) Diastolic properties of the left ventricle. In: Levine HJ, Gaasch WH (eds) The left ventricle. Basic and clinical aspects. Martinus Nijhoff, Boston, pp 143–170
Forrester JS, Diamond G, Chatterjee K, Swan HJC (1976) Medical therapy of acute myocardial infarction by application of hemodynamic subsets. N Engl J Med 295: 1356–1362, 1404–1413
Grossman W, Braunwald E, Mann T, McLaurin LP, Green LH (1977) Contractile state of the left ventricle in man as evaluated from end-systolic pressure-volume relations. Circulation 56: 845–852
Sonnenblick EH (1962) Force-velocity relations in mammalian heart muscle. Am J Physiol 202: 931–939
Spann JF, Bove AA, Natarajan G, Kreulen T (1980) Ventricular performance, pump function, and compensatory mechanisms in patients with aortic stenosis. Circulation 62: 576–582
Carabello BA, Nolan SP, McGuire LB (1981) Assessment of preoperative left ventricular function in patients with mitral regurgitation: Value of the end-systolic stress end-systolic volume ratio. Circulation 64: 1212–1217
Hirota Y, Shimizu G, Kaku K, Saito T, Kawamura K (1983) Two dimensional analysis of left ventricular function by afterload ejection fraction and end-systolic stress volume relationships, (abstract) Circulation (Suppl III) 68: 238
Ross J Jr (1976) Afterload mismatch and preload reverve. A conceptual framework for the analysis of ventricular function. Prog Cardiovasc Dis 18: 255–264
Gunther S, Grossman W (1979) Determinants of ventricular function in pressure-overload hypertrophy in man. Circulation 59: 679–688
Carabello BA, Green LH, Grossman W, Cohn LH, Koster JK, Collins JJ Jr (1980) Hemodynamic determinants of prognosis of aortic valve replacement in critical aortic stenois and advanced congestive heart failure. Circulation 62: 42–48
Grossman W, Jones D, McLaurin LP (1975) Wall stress and patterns of hypertrophy in the human left ventricle. J Clin Invest 56: 56–64
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© 1989 Springer-Verlag Tokyo
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Hirota, Y., Shimizu, G., Kita, Y., Kawamura, K. (1989). Assessment of Cardiac Function in Diseased Heart by Catheterization Study. In: Hori, M., Suga, H., Baan, J., Yellin, E.L. (eds) Cardiac Mechanics and Function in the Normal and Diseased Heart. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67957-8_28
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DOI: https://doi.org/10.1007/978-4-431-67957-8_28
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