Assessment of the Frank-Starling relationship by two-dimensional echocardiography.
The Frank-Starling relationship between left ventricular stroke work and end-diastolic minor-axis cross-sectional area was evaluated as a load-insensitive measure of inotropic state by two-dimensional echocardiography in 10 conscious dogs. Stroke work was calculated as the product of systolic change in cross-sectional area and either (1) beat-to-beat mean arterial pressure or (2) initial systolic blood pressure. Both Frank-Starling relationships were highly linear during preload variation (mean r = 0.96), sensitive to the inotropic state (slope increase with calcium 51% +/- 43% and 62% +/- 53%, respectively), and insensitive to afterload (r < 0.4, slope or x intercept versus afterload). Thus the Frank-Starling relationships derived from two-dimensional echocardiographic images and peripheral arterial pressure may be a useful and practical means of assessing inotropic state with minimally invasive measurements.
Zipprich
D A
DA
Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Owen
C H
CH
Lewis
C W
CW
Gall
S A
SA
Davis
J W
JW
Kisslo
J A
JA
Glower
D D
DD
D000818:Animals; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001810:Blood Volume / Q000187:drug effects / Q000502:physiology; D002122:Calcium Chloride / Q000008:administration & dosage; D002306:Cardiac Volume / Q000187:drug effects / Q000502:physiology; D003971:Diastole / Q000187:drug effects / Q000502:physiology*; D004285:Dogs; D004452:Echocardiography / Q000295:instrumentation*; D005583:Fourier Analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008955:Models, Cardiovascular; D009599:Nitroprusside / Q000008:administration & dosage; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology; D010656:Phenylephrine / Q000008:administration & dosage; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology*; D013599:Systole / Q000187:drug effects / Q000502:physiology; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology*
D009599:Nitroprusside; D010656:Phenylephrine; D002122:Calcium Chloride