Journal article
Left ventricular volume analysis as a basic tool to describe cardiac function
Advances in physiology education, v 42(1)
01 Mar 2018
PMID: 29446315
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The heart is often regarded as a compression pump. Therefore, determination of pressure and volume is essential for cardiac function analysis. Traditionally, ventricular performance was described in terms of the Starling curve, i.e., output related to input. This view is based on two variables (namely, stroke volume and end-diastolic volume), often studied in the isolated (i.e., denervated) heart, and has dominated the interpretation of cardiac mechanics over the last century. The ratio of the prevailing coordinates within that paradigm is termed ejection fraction (EF), which is the popular metric routinely used in the clinic. Here we present an insightful alternative approach while describing volume regulation by relating end-systolic volume (ESV) to end-diastolic volume. This route obviates the undesired use of metrics derived from differences or ratios, as employed in previous models. We illustrate basic principles concerning ventricular volume regulation by data obtained from intact animal experiments and collected in healthy humans. Special attention is given to sex-specific differences. The method can be applied to the dynamics of a single heart and to an ensemble of individuals. Group analysis allows for stratification regarding sex, age, medication, and additional clinically relevant covariates. A straightforward procedure derives the relationship between EF and ESV and describes myocardial oxygen consumption in terms of ESV. This representation enhances insight and reduces the impact of the metric EF, in favor of the end-systolic elastance concept advanced 4 decades ago.
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Details
- Title
- Left ventricular volume analysis as a basic tool to describe cardiac function
- Creators
- Peter L. M. Kerkhof - Amsterdam UMC Location VUmcTatiana Kuznetsova - KU LeuvenRania Ali - Amsterdam UMC Location VUmcNeal Handly - Drexel University
- Publication Details
- Advances in physiology education, v 42(1)
- Publisher
- Amer Physiological Soc
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Emergency Medicine
- Web of Science ID
- WOS:000429538600002
- Scopus ID
- 2-s2.0-85046445206
- Other Identifier
- 991019167738804721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Education, Scientific Disciplines
- Physiology