Ventricular end systolic

This trace shows the volume of the left ventricle throughout the cycle. The important point is the atrial kick seen at point a. Loss of this kick in atrial fibrillation and other conditions can adversely affect cardiac function through impaired LV filling. The maximal volume occurs at the end of diastolic filling and is labelled the left ventricular end-diastolic volume (LVEDV). In the same way, the minimum volume is the left ventricular end-systolic volume (LVESV). The difference between these two values must, therefore, be the stroke volume (SV), which is usually 70 ml as demonstrated above. The ejection fraction (EF) is the SV as a percentage of the LVEDV and is around 60% in the diagram above. 

There is a theoretical contraindication to nicorandil in patients with cardiogenic shock, acute left ventricular failure with low fiUing pressure, and hypotension. A sublingual dose of 20 mg in patients with coronary artery disease and normal left ventricular function was associated with a 12% fall in left ventricular end-systolic pressure, a 3% fall in left ventricular end-diastolic pressure, accentuated diastohc filhng, a 13% reduction in mean aortic pressure, and a reduced cardiac output at rest (9,30). However, cardiac output may be augmented by up to 60% in patients with congestive cardiac failure or... 

Park RC, Little WC, O Rourke RA. Effect of alternation of left ventricular activation sequence on the left ventricular end-systolic pressure-volume relation in closed-chest dogs. Circ Res 1985 57(5) 706—17. 

In addition to improving symptoms, randomized clinical trials have also shown that conventionally indicated patients derive objective evidence of beneficial structural changes (often referred to as reverse remodeling) in response to CRT. Resynchronization reduces left ventricular end-systolic (10,18-19) and end-diastolic volumes (10,22,23), and increases left ventricular ejection fraction (10,21,23). The improvements in ejection fraction ranged from 2% to 7% and are noteworthy given that the baseline ejection fractions in these trials were in the range... 

Over the past decade, we (Sagawa, 1978) have measured the ventricular pressure (P)-volume (V) relationship in an isolated and blood perfused canine heart preparation and came to consider that the ventricular end-systolic P-V relationship (ESPVR) is (a) linear as opposed to the highly nonlinear P-V relationship of the frog s ventricle reported by Otto Frank a century ago, (b) rather insensitive to the preload and afterload and (c) changes its slope (E, ) sensitively with inotropic interventions without a significant shift in the volume intercept (Vq). This is to say that our model of the ventricle merely consists of a linear volume elastance E which varies with each heart beat from a smaller end-diastolic value to a larger... 

Equation (2) states that, given an end-diastolic volume 5V is inversely proportional to (the line coursing from the lower left to upper right corner of the bottom panel of Figure 1). This rectilinear relation is denoted the ventricular end-systolic pressure-stroke volume relationship (VPSVR) . 

Figure 1. Schematic explanation of coupling the left ventricular contraction with the systemic arterial tree. In the middle left panels, left ventricular contraction is represented by its end-systolic pressure-volume relationship. Given a particular end diastolic volume (EDV), this relationship can be converted into ventricular end-systolic pressure P s) stroke volume (5Vj relationship, which is shown by the rectilinear curve coursing from the lower left to upper right corner in the graph at the bottom. In the right middle panel, the aortic input impedance property is represented by a rectilinear arterial end-systolic pressure fF, )-stroke volume SV) relationship curve (Eq. (5)). See the text for the explanation of this representation. This arterial Pes-SV relationship is transcribed in the bottom panel in superposition with the ventricular Pe -SV relationship. The intersection of the two Pes-SV relationship curves indicates the end-systolic pressure and stroke volume which should result from coupling a left ventricle with the given EDV and the slope parameter with a systemic arterial tree with the slope parameter...

Fig. 6.3 Hemodynamic profile of CAS 1609 on anesthetised dog (0.3mgkg 1 i.v.) systolic blood pressure (BPs), diastolic blood pressure (BPd), left ventricular end diastolic pressure (LVEDP), diastolic pulmonary artery pressure (PAPd), heart rate (HR), left ventricular...

Cardiovascular Heart weight, wall thickness, left ventricular (LV) and right ventricular (RV) end-diastolic and end-systolic lumen volumes (EDV and ESV, respectively), cardiac output (CO), heart rate, and LV diastolic filling pressure Magnetic resonance imaging Dog Opie189... 

Pharmacology The principal pharmacological action of nitrates is relaxation of the vascular smooth muscle and consequent dilation of peripheral arteries and especially the veins. Dilation of the veins promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload). Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (afterload). Dilation of the coronary arteries also occurs. The relative importance of preload reduction, afterload reduction, and coronary dilation remains undefined. 

The usual cause of pulmonary edema is acute left ventricular failure. The sequelae of events after left heart failure roughly follow the pattern of reduced stroke volume, leading to increased end-systolic and diastolic volume, which elevates left ventricular end-diastolic pres-... 

Cardiac function may be evaluated by the determination of left (or right) ventricular ejection fraction (VEF). In this procedure, regions of interest are defined at the end diastolic and end systolic phases of heart beat. The ejection fraction is defined as the ratio of tracer (blood) in the heart in the contracted (systolic) versus the relaxed (diastolic) phases of the heart cycle with appropriate corrections for decay and gamma camera dead time. The value obtained provides a measure of the ability of the heart to pump blood through the lungs (RVEF) or the body (LVEF). A criticism of Ir-191m for this application has been that the half-life (4.96s) is too short to allow effective visualization and quantitation of left ventricular function in adults, particularly those with delayed transit times. A recent... 

Left ventricular end-diastolic (LVEDP) and peak systolic pressure (mm Hg)... 

Frames corresponding to end diastole and end systole are identified from each cine sequence and regions-of-interest (ROI) drawn around the left ventricular (LV) epi- and endocardial borders using ParaVision software (Bruker). The area of the ROIs is summed and multiplied by the inter-slice distance (5 mm) to calculate the end diastolic and end systolic volumes (EDV and ESV) of the whole ventricle and lumen. Other cardiac parameters are calculated as follows ... 

Myocardial function is assessed as left ventricular developed pressure (LVDP) defined as the difference between the LV end-systolic and diastolic pressures, measured at pre-ischemic, ischemic, and post-ischemic times (5, 10, 15, 20, 25, and 30 min of reperfiision) (18)(see Note 2). 

Restrictive cardiomyopathy is primarily an abnormality of diastolic function that results in impaired filling and increases in ventricular end-diastolic pressures with normal or decreased diastolic volume. It is associated with normal systolic function early in the course of the disease but a decrease in systolic function later in the disease... 

Burns RJ, Gibbons RJ, Yi Q, et al. The relationships of left ventricular ejection fraction, end-systolic volume index and infarct size to six-month mortality after hospital discharge following myocardial infarction treated by thrombolysis. J Am... 

WuE, Ortiz JT, Tejedor P, et al. Infarct size by contrast enhanced cardiac magnetic resonance is a stronger predictor of outcomes than left ventricular ejection fraction or end-systolic volume index prospective cohort study. Heart 2008 94(6) 730—6. 

Piezoelectric sensors are useful for assessment of myocardial function after acute ischemic injury (as a function of occluding regional coronary blood flow). Figure 2.21 shows preischemic base line conditions and postischemic myocardial dysfunction. Ventricular pressure-segmental length loops and end-systolic pressure-length relationships under control conditions (preischemia) and 15 min after coronary occlusion (ischemia) are illustrated. 

Mechanical effects The increase in contractility evoked by digitalis results in increased ventricular ejection, decreased end-systolic and end-diastolic size, increased cardiac output, and increased renal perfusion. These beneficial effects permit a decrease in the compensatory sympathetic and renal responses previously de.scribed. The decrease in sympathetic... 

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