Electrical and hemodynamic correlates of the maximal rate of pressure increase in the human left ventricle

Abstract

Background: The rate of left ventricular (LV) pressure increase ( LV +dP dt ) may be related to QRS duration, as well as to a number of hemodynamic parameters. Methods and Results: We studied the relation between basal LV +dP dt and QRS duration in 43 patients with normal LV function and 81 patients with heart failure undergoing diagnostic catheterization. We also examined the relationship between LV +dP dt and heart rate, as well as measures of both LV preload and afterload. In patients with normal LV function, there was a strong relationship between basal LV +dP dt and resting heart rate, whereas the relationship with QRS duration was of borderline significance. In patients with heart failure, the relationship with heart rate was lost; however, LV systolic pressure, QRS duration, and LV end-diastolic pressure all made significant contributions to a model predicting LV +dP dt . Conclusions: These data show a strong relationship between resting heart rate and LV +dp dt in the healthy human LV. In patients with heart failure, the relationship with heart rate is not maintained; however, there is a systematic relationship between LV +dP dt and both the time-course of the electrical activation and measures of LV loading conditions.