Linear end-systolic pressure-volume relationship during pulsatile left ventricular bypass represents native heart function

Abstract

This study assessed whether the end-systolic pressure-volume relationship obtained without any interventions during pulsatile left ventricular bypass adequately represents native heart function. In 11 anesthetized Holstein calves, left ventricular pressure was measured with a micromanometer while left ventricular volume was simultaneously calculated from orthogonal left ventricular diameters measured with ultrasonic dimension transducers. End-systolic pressure and volume data were subjected to linear regression analysis to achieve an end-systolic pressure-volume relationship. Data from both caval occlusions and aortic occlusion were used for the control end-systolic pressure-volume relationship (median r = 0.941, slope = 7.4 ± 0.8 mm Hg per milliliter per 100 gm left ventricular weight; mean ± standard error of the mean). During left atrial-aortic bypass with a Pierce-Donachy pneumatic assist pump in the asynchronous mode, the end-systolic pressure-volume relationships were obtained without interventions to change ventricular loading conditions. During maximal ventricular unloading during full to empty pumping, termed 100%, the resulting narrow range of pressure and volume data did not yield highly linear end-systolic pressure-volume relationships (median r = 0.669, slope = 4.9 ± 0.9 mm Hg per milliliter per 100 gm left ventricular weight). However, at reduced rates off pumping, the end-systolic pressure-volume relationships were considerably linear (80%, median r = 0.819; 60%, median r = 0.868; 40%, median r = 0.899). Slopes did not significantly differ from control values (80%, 6.9 ± 1.1; 60%, 8.2 ± 1.1; 40%, 7.8 ± 1.1). The end-systolic pressure-volume relationship obtained without exogenous load changes during asynchronous, pulsatile left ventricular bypass represents native left ventricular systolic function. (J T HORAC C ARDIOVASC S URG 1995;109:780-6)