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Left ventricular function: time-varying elastance and left ventricular aortic coupling Walley, Keith R. (Keith Robert)
Abstract
Many aspects of left ventricular function are explained by considering ventricular pressure–volume characteristics. Contractility is best measured by the slope, Emax, of the end-systolic pressure–volume relationship. Ventricular systole is usefully characterized by a time-varying elastance (ΔP/ΔV). An extended area, the pressure–volume area, subtended by the ventricular pressure–volume loop (useful mechanical work) and the ESPVR (energy expended without mechanical work), is linearly related to myocardial oxygen consumption per beat. For energetically efficient systolic ejection ventricular elastance should be, and is, matched to aortic elastance. Without matching, the fraction of energy expended without mechanical work increases and energy is lost during ejection across the aortic valve. Ventricular function curves, derived from ventricular pressure–volume characteristics, interact with venous return curves to regulate cardiac output. Thus, consideration of ventricular pressure–volume relationships highlight features that allow the heart to efficiently respond to any demand for cardiac output and oxygen delivery.
Item Metadata
Title |
Left ventricular function: time-varying elastance and left ventricular aortic coupling
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Creator | |
Contributor | |
Publisher |
BioMed Central
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Date Issued |
2016-09-10
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Description |
Many aspects of left ventricular function are explained by considering ventricular pressure–volume characteristics. Contractility is best measured by the slope, Emax, of the end-systolic pressure–volume relationship. Ventricular systole is usefully characterized by a time-varying elastance (ΔP/ΔV). An extended area, the pressure–volume area, subtended by the ventricular pressure–volume loop (useful mechanical work) and the ESPVR (energy expended without mechanical work), is linearly related to myocardial oxygen consumption per beat. For energetically efficient systolic ejection ventricular elastance should be, and is, matched to aortic elastance. Without matching, the fraction of energy expended without mechanical work increases and energy is lost during ejection across the aortic valve. Ventricular function curves, derived from ventricular pressure–volume characteristics, interact with venous return curves to regulate cardiac output. Thus, consideration of ventricular pressure–volume relationships highlight features that allow the heart to efficiently respond to any demand for cardiac output and oxygen delivery.
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Genre | |
Type | |
Language |
eng
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Date Available |
2017-12-11
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Provider |
Vancouver : University of British Columbia Library
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Rights |
Attribution 4.0 International (CC BY 4.0)
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DOI |
10.14288/1.0361801
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URI | |
Affiliation | |
Citation |
Critical Care. 2016 Sep 10;20(1):270
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Publisher DOI |
10.1186/s13054-016-1439-6
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Peer Review Status |
Reviewed
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Scholarly Level |
Faculty
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Copyright Holder |
Walley.
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Rights URI | |
Aggregated Source Repository |
DSpace
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Item Media
Item Citations and Data
Rights
Attribution 4.0 International (CC BY 4.0)