Non invasive evaluation of left ventricular elastance according to pressure-volume curves modeling in arterial hypertension
| Autor: | Guilhem du Cailar, Franck Jourdan, Pierre Fesler, Benjamin Bonnet |
|---|---|
| Přispěvatelé: | Hôpital Lapeyronie [Montpellier] (CHU), Biomécanique des Interactions et de l'Organisation des Tissus et des Cellules (BIOTIC), Laboratoire de Mécanique et Génie Civil (LMGC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Biocommunication en Cardio-Métabolique (BC2M), Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Gibier, François |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pressure-volume curves medicine.medical_specialty Time Factors hypertension Manometry Physiology Echocardiography Three-Dimensional left ventricular elastance 030204 cardiovascular system & hematology Ventricular Function Left Ventricular Dysfunction Left 03 medical and health sciences 0302 clinical medicine [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Predictive Value of Tests Physiology (medical) Internal medicine [SPI.MECA.BIOM] Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph] Ventricular Pressure medicine three-dimensional echocardiography Humans Arterial Pressure 030212 general & internal medicine Least-Squares Analysis Aged Ventricular Remodeling business.industry Models Cardiovascular Reproducibility of Results [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph] Three dimensional echocardiography Middle Aged Echocardiography Doppler Elasticity [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Nonlinear Dynamics Case-Control Studies Linear Models Cardiology Feasibility Studies Female Hypertrophy Left Ventricular Cardiology and Cardiovascular Medicine business Ventricular elastance |
| Zdroj: | AJP-Heart and Circulatory Physiology AJP-Heart and Circulatory Physiology, American Physiological Society, 2017, 313 (2), pp.H237-H243. ⟨10.1152/ajpheart.00086.2017⟩ AJP-Heart and Circulatory Physiology, 2017, 313 (2), pp.H237-H243. ⟨10.1152/ajpheart.00086.2017⟩ |
| ISSN: | 0363-6135 1522-1539 |
| DOI: | 10.1152/ajpheart.00086.2017⟩ |
| Popis: | End-systolic left ventricular (LV) elastance ( Ees) has been previously calculated and validated invasively using LV pressure-volume (P-V) loops. Noninvasive methods have been proposed, but clinical application remains complex. The aims of the present study were to 1) estimate Ees according to modeling of the LV P-V curve during ejection (“ejection P-V curve” method) and validate our method with existing published LV P-V loop data and 2) test the clinical applicability of noninvasively detecting a difference in Ees between normotensive and hypertensive subjects. On the basis of the ejection P-V curve and a linear relationship between elastance and time during ejection, we used a nonlinear least-squares method to fit the pressure waveform. We then computed the slope and intercept of time-varying elastance as well as the volume intercept (V0). As a validation, 22 P-V loops obtained from previous invasive studies were digitized and analyzed using the ejection P-V curve method. To test clinical applicability, ejection P-V curves were obtained from 33 hypertensive subjects and 32 normotensive subjects with carotid tonometry and real-time three-dimensional echocardiography during the same procedure. A good univariate relationship ( r2 = 0.92, P < 0.005) and good limits of agreement were found between the invasive calculation of Ees and our new proposed ejection P-V curve method. In hypertensive patients, an increase in arterial elastance ( Ea) was compensated by a parallel increase in Ees without change in Ea/ Ees. In addition, the clinical reproducibility of our method was similar to that of another noninvasive method. In conclusion, Ees and V0 can be estimated noninvasively from modeling of the P-V curve during ejection. This approach was found to be reproducible and sensitive enough to detect an expected increase in LV contractility in hypertensive patients. Because of its noninvasive nature, this methodology may have clinical implications in various disease states. NEW & NOTEWORTHY The use of real-time three-dimensional echocardiography-derived left ventricular volumes in conjunction with carotid tonometry was found to be reproducible and sensitive enough to detect expected differences in left ventricular elastance in arterial hypertension. Because of its noninvasive nature, this methodology may have clinical implications in various disease states. |
| Databáze: | OpenAIRE |
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