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See detailDeterminants of left ventricular preload-adjusted maximal power
Segers, Patrick; Tchano-Sato, Vincent; Leather, H. Alex et al

in American Journal of Physiology - Heart and Circulatory Physiology (2003), 284(6), 2295-2301

Maximal left ventricular (LV) hydraulic power output (PWRmax), corrected for preload as PWRmax/(V-ed)(beta) (where V-ed is the end-diastolic volume and beta is a constant coefficient), is an index of LV ... [more ▼]

Maximal left ventricular (LV) hydraulic power output (PWRmax), corrected for preload as PWRmax/(V-ed)(beta) (where V-ed is the end-diastolic volume and beta is a constant coefficient), is an index of LV contractility. Whereas preload-adjusted maximal power (PAMP) is usually calculated with beta = 2, there is uncertainty about the optimal value of beta (beta = 1 for the normal LV and 2 for the dilated LV). The aim of this work is to study the determining factors of beta. The data set consisted of 245 recordings (steady state and vena cava occlusion) in 10 animals in an ischemic heart pig model. The occlusion data yielded the slope (E-es; 2.01 +/- 0.77 mmHg/ml, range 0.71-4.16 mmHg/ml) and intercept (V-0; -11.9 +/- 22.6 ml; range -76 to 39 ml) of the end-systolic pressure-volume relation, and the optimal beta-factor (assessed by fitting an exponential curve through the V-ed-PWRmax relation) was 1.94 +/- 0.88 (range 0.29-4.73). The relation of beta with V-ed was weak [beta = 0.60 + 0.02(V-ed); r(2) = 0.20]. In contrast, we found an excellent exponential relation between V-0 and beta [beta = 2.16e(0.0189(V0)), r(2) = 0.70]. PAMP, calculated from the steady-state data, was 0.64 +/- 0.40 mW/ml(2) (range 0.14-2.83 mW/ml(2)) with a poor correlation with E-es (r = 0.30, P < 0.001). An alternative formulation of PAMP as PWRmax/(V-ed - V-0)(2), incorporating V-0, yielded 0.47 +/- 0.26 mW/ml(2) (range 0.09-1.42 mW/ml(2)) and was highly correlated with E-es (r = 0.89, P < 0.001). In conclusion, correct preload adjustment of maximal LV power requires incorporation of V-0 and thus of data measured under altered loading conditions. [less ▲]

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See detailRight ventricular diastolic function in acute pulmonary embolism
Morimont, Philippe ULg; segers, P.; Ghuysen, Alexandre ULg et al

Poster (2003)

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See detailArterial elastance and heart-arterial coupling in aortic regurgitation are determined by aortic leak severity
Segers, P.; Morimont, Philippe ULg; Kolh, Philippe ULg et al

in American Heart Journal (2002), 144(4), 568-576

Background In aortic valve regurgitation (AR), aortic leak severity modulates left ventricle (LV) arterial system interaction. The aim of this study was to assess (1) how arterial elastance (E-a ... [more ▼]

Background In aortic valve regurgitation (AR), aortic leak severity modulates left ventricle (LV) arterial system interaction. The aim of this study was to assess (1) how arterial elastance (E-a), calculated as the ratio of LV end-systolic pressure and stroke volume, relates to arterial properties and leak severity and (2) the validity of E-a/E-max (with E-max the slope of the-end-systolic pressure-volume relation) as a heart-arterial coupling parameter in AR. Methods and Results Our work is based on human data obtained from a study on vascular adaptation in chronic AR. These data allowed us to assess the parameters of a computer model of heart-arterial interaction. In particular, total peripheral resistance (R) and aortic leak severity-expressed as leak resistance (R-L,R-ao)-were quantified for different patient subgroups (group I/IIa/IIb: E-max = 2.15/0.62/0.47 mm Hg/mL; E-a = 1.24/0.66/0.90 mm Hg/mL; R = 1.9/0.6/0.85 mm Hg-s/mL, R-L,R-ao = 0.35/0.05/0.20 mm Hg-s/mL). A parameter study demonstrated that R-L,R-ao was the main determinant of E-a. With all other parameters constant, valve repair would increase E-a to 2.81, 1.08, and 1.54 mm Hg/mL in groups I,IIa, and IIb, respectively. For a given E-a/E-max, LV pump efficiency (estimated as the ratio of stroke work and LV systolic pressure-volume area) was lower than the theoretical predicted value, except for the simulations with intact aortic valve. Conclusions In AR(a) E-a is determined by aortic leak severity rather than by arterial system properties. Using E-a/E-max as a coupling parameter in general or as a mechanico-energetic regulatory parameter in particular is questionable. [less ▲]

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See detailEvolution of ventriculo-arterial coupling during acute myocardial ischemia
Kolh, Philippe ULg; D'Orio, Vincenzo ULg; LAMBERMONT, Bernard ULg et al

in European Heart Journal (2001), 22

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See detailEffect of hemodiafiltration on pulmonary hemodynamics in a model of porcin endotoxin shock
Moonen, Marie ULg; LAMBERMONT, Bernard ULg; Kolh, Philippe ULg et al

in Journal of the American Society of Nephrology [=JASN] (2001), 12

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