[Invasive diagnostic technique for heart failure].
Invasive techniques have been important to assess the ventricular function. The approach for assessing function is based on measurement of cardiac output which depends on preload, afterload and contractility. Stroke work over a range of end-diastolic pressures was examined and termed the function curve. Clinical application of Frank-Starling principle is useful for characterizing heart failure. The isovolumic phase (positive dp/dt) and ejection phase index (ejection fraction) are responsive to acute change in contractility. The pressure-volume loop can be constructed by measurement of pressure and volume. The slope of end-systolic pressure-volume relation (ESPVR) is an expression of contractility. The linear relationship between stroke work and end-diastolic volume has been also proposed. The arterial system is characterized by the end-systolic pressure-stroke volume relationship and the slope is called as effective arterial elastance (Ea). One can evaluate stroke volume by coupling frame work between ESPVR and Ea. The isovolumic indices during diastole (negative dp/dt, time constant) can show impaired relaxation. The several factors influence the diastolic pressure-volume relation.
Takeuchi
M
M
1st Department of Medicine, Kobe University School of Medicine.
D006328:Cardiac Catheterization; D002302:Cardiac Output; D002306:Cardiac Volume; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D009200:Myocardial Contraction; D013318:Stroke Volume; D016276:Ventricular Function