AI Article Synopsis
- The study aimed to assess how a sudden decrease in systemic afterload impacts the accuracy of Doppler measurements of left ventricular pressure rise compared to other common indicators of heart function.
- Twelve patients undergoing heart surgery were monitored as afterload was reduced using nicardipine, measuring several heart function metrics at each stage.
- Results showed a significant correlation between reduced systemic vascular resistance and Doppler-derived LV DeltaP/Delta(t), indicating it accurately reflects heart contractility, unlike other measures that may overestimate it during reduced afterload conditions.
Article Abstract
Objectives: This study was designed to describe exactly the effects of acute decrease in systemic afterload on the accuracy of Doppler-derived left ventricular rate of pressure rise (LV DeltaP/Delta(t)) measurements compared with other routinely used indices of systolic function.
Methods: Twelve patients scheduled for coronary artery bypass grafting were studied. After induction of anesthesia (T0), afterload was modified by incremental administrations of nicardipine (T1-4). At each step of the procedure, thermodilution-derived cardiac index, left ventricular (LV) fractional area change, and LV DeltaP/Delta(t) were measured, and systemic vascular resistances were calculated.
Results: During the procedure, the systemic vascular resistances decrease averaged 13.4%. Systemic vascular resistances were correlated with LV DeltaP/Delta(t) (r = 0.843, P =.003) but inversely correlated with cardiac index (r = -0.782, P =.005) and LV fractional area change (r = -0.887, P =.003).
Conclusion: In conclusion, and inversely to cardiac index or LV fractional area change, LV DeltaP/Delta(t) does not overestimate LV contractility in the presence of an acute decrease in systemic afterload.
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| http://dx.doi.org/10.1067/mje.2001.115457 | DOI Listing |
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