Abstract

The cardiac pumping mechanics can be characterized by both the maximal systolic elastance (Emax) and theoretical maximum flow (Qmax), which are generated using an elastance–resistance model. The signals required to fit the elastance–resistance model are the simultaneously recorded left ventricular (LV) pressure and aortic flow (Qm), followed by the isovolumic LV pressure. In this study, we evaluated a single-beat estimation technique for determining the Emax and Qmax by using the elastance–resistance model based solely on the measured LV pressure and cardiac output. The isovolumic LV pressure was estimated from the measured LV pressure by using a non-linear least-squares approximation technique. The measured Qm was approximated by an unknown triangular flow (Qtri), which was generated by using a fourth-order derivative of the LV pressure. The Qtri scale was calibrated using the cardiac output. Values of EmaxtriQ and QmaxtriQ obtained using Qtri were compared with those of EmaxmQ and QmaxmQ obtained from the measured Qm. Healthy rats and rats with chronic kidney disease or diabetes mellitus were examined. We found that the LV Emax and Qmax can be approximately calculated using the assumed Qtri, and they strongly correlated with the corresponding values derived from Qm (P < 0.0001; n = 78): EmaxtriQ = 51.9133 + 0.8992 × EmaxmQ (r2 = 0.8257; P < 0.0001); QmaxtriQ = 2.4053 + 0.9767 × QmaxmQ (r2 = 0.7798; P < 0.0001). Our findings suggest that the proposed technique can be a useful tool for determining Emax and Qmax by using a single LV pressure pulse together with cardiac output.

Highlights

  • An elastance–resistance model is an effective tool to quantify the systolic pumping mechanics of the heart in in situ, openchest experiments [5, 14, 21, 22]

  • The left ventricular (LV) end-systolic elastance (Ees) is the slope of the ESPVsR line, which was obtained from the measured LV pressure (1a), the estimated isovolumic pressure (1b), and the time integration of aortic flow by using either Qm or Qtri

  • We demonstrated that the elastance–resistance model with either the Qm or Qtri could be satisfactorily applied to measure the intrinsic LV systolic mechanics within the specified fitting interval

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Summary

Introduction

An elastance–resistance model is an effective tool to quantify the systolic pumping mechanics of the heart in in situ, openchest experiments [5, 14, 21, 22] Parameters generated by this model to characterize the cardiac physical processes are maximal systolic elastance (Emax) and theoretical maximum flow (Qmax). A curve-fitting technique, proposed by Sunagawa et al [26], was performed to estimate the isovolumic LV pressure by using the recorded instantaneous LV pressure of an ejecting contraction. They discovered that an elastance–resistance model with the estimated isovolumic LV pressure can potentially be used to study the systolic pumping mechanics of the heart

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