The Left Ventricular End-Systolic Pressure and Pressure-Volume Index. Comparison Between Invasive and Auscultatory Arm Pressure Measurements

Abstract

The slope of the left ventricular (LV) end-systolic pressure-volume relation (ESPVR) has been established as a valuable clinical method to assess LV contractile function independent of LV loading factors. The purpose of the present study was to evaluate whether the ESPVR could be reliably determined from auscultatory blood pressure (BP) measurements and from LV volume measurement by contrast ventriculography (CVG). Twenty-four patients with suspected or known ischemic heart disease were studied by cardiac catheterization with simultaneous, blinded, intravascular and auscultatory pressure measurements. LV volume was determined by CVG. The auscultatory mean arterial blood pressure (MAP) derived from: [formula: see text] was found to be a useful measure of the LV end-systolic pressure in this connection. The correlation between invasively measured LV end-systolic pressure (ESP) and MAP was highly significant (r = 0.82; SEE = 6.9 mmHg; p = 0.001). The correlation between invasively and semi-invasively measured ESPVR fell close to the line of identity (r = 0.99; SEE = 0.23 mmHg.mL-1; p < 0.001). The replacement of ESP by MAP induced only a minimal error in the assessment of the ESPVR. A complete noninvasive determination of the ESPVR and LV contractility therefore seems possible by using the MAP and by measuring the end-systolic volume by radionuclide ventriculography or by echocardiography.