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Left ventricular outflow tract mean systolic acceleration as a surrogatefor the slope of the left ventricular end-systolic pressure-volume relationship

Fabrice Bauer, MD^*, Michael Jones, MD, Takahiro Shiota, MD, FACC^*,*, Michael S. Firstenberg, MD^*, Jian Xin Qin, MD^*, Hiroyuki Tsujino, BSc^*, Yong Jin Kim, MD^*, Marta Sitges, MD^*, Lisa A. Cardon, RDCS^*, Arthur D. Zetts and James D. Thomas, MD, FACC^*

^* Cleveland Clinic Foundation, Cleveland, Ohio, USA
National Heart, Lung, and Blood Institute of Health, Bethesda, Maryland, USA

View larger version (29K): [in a new window]   Figure 1 An example of left ventricular (LV) pressure-volume relationship recording from an invasive conductance catheter (left) and LV outflow tract pulsed-wave Doppler recording from the apical view. Left ventricular outflow tract acceleration was calculated as peak velocity ÷ time to peak velocity (right).

View larger version (40K): [in a new window]   Figure 2 An example of left ventricular pressure-volume relationship (top), left ventricular outflow tract (LVOT) velocity (middle), and hemodynamic flow velocity data with numerical simulation modeling (bottom) for a sheep with chronic myocardial infarction at baseline, after blood infusion, after angiotensin infusion, after nitroprusside infusion, and during acute coronary occlusion.

View larger version (18K): [in a new window]   Figure 3 Comparison between left ventricular (LV) outflow tract acceleration (LVOTAcc) (y axis) calculated from peak aortic flow velocity/time to peak velocity and LV maximal elastance (Em) from pressure-volume loops (x-axis) in 82 hemodynamic conditions. Solid triangles = during change in loading conditions; open triangles = during acute coronary occlusion.

View larger version (16K): [in a new window]   Figure 4 Comparison between left ventricular (LV) maximal elastance (Em) calculated from predicted LV outflow tract systolic acceleration (y axis) and actual pressure-volume loops (x axis) in 82 hemodynamic conditions.