Initiation of ventricular contraction as reflected in the aortic pressure waveform

Abstract

Prior to aortic valve opening, aortic pressure is perturbed by ventricular contraction. The onset of this pressure perturbation coincides with the onset of the left ventricular (LV) isovolumic contraction, and hence will be referred to as the start of the arterially detected isovolumic contraction (AICstart). In the present study we test the hypothesis that the pressure perturbation indeed has a cardiac origin. In ten Yorkshire–Landrace swine, waveform intensity analysis demonstrated that AICstart was followed by a positive intensity wave (0.3 × 105 ± 0.3 × 105 W (m2 s2)–1). Timing analysis of LV and aortic pressure waveform showed that AICstart was preceded by a LV pressure perturbation (3.8 ± 1.8 ms, p < 0.001). These novel cardiac timing and aortic wave intensity findings reveal the cardiac origin of the pressure perturbation. In 15 Yorkshire–Landrace swine, myocardial motion analysis showed a significantly higher rate of segment shortening during the first part of the LV pressure perturbation. Therefore, both the LV and aortic pressure perturbation are most likely caused by the early phase of myocardial contraction, which also causes mitral valve closure. Consequently, AICstart is useful in the determination of the isovolumic contraction period, a well-known marker to quantify cardiac dysfunction.