Clinical evaluation of left heart function by conductance catheter technique.
Methods to obtain pressure-volume loops in humans and their application to clinical diagnosis and treatment of cardiac disease are discussed. The method employs a conductance catheter, micromanometer, and inferior vena caval balloon occluder to reversibly and rapidly vary venous return. Multiple cardiac cycles measured during this manoeuvre are used to derive a variety of systolic and diastolic function indices, as well as estimates of vascular loading, and cardiac energetics. Strengths and weaknesses of the method as well as pressure-volume indexes themselves are briefly discussed. Lastly, three clinical examples are presented which serve to demonstrate how pressure-volume analysis can provide useful clinical information regarding diagnosis and/or treatment in subjects with heart failure symptoms.
Kass
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DA
Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
D001281:Atrial Fibrillation / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D001810:Blood Volume / Q000502:physiology; D006328:Cardiac Catheterization / Q000295:instrumentation*; D003196:Computer Graphics; D003971:Diastole / Q000502:physiology; D004562:Electrocardiography / Q000295:instrumentation; D006333:Heart Failure / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008365:Manometry / Q000295:instrumentation; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009205:Myocarditis / Q000503:physiopathology; D009862:Online Systems / Q000295:instrumentation; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D013815:Thermodilution / Q000295:instrumentation; D016277:Ventricular Function, Left / Q000502:physiology*