Radionuclide determination of the relationship between left ventricular contractile state and ejection fraction

Mark R. Starling, Milton D. Gross, Richard A. Walsh, G. B John Mancini, Ralph Blumhardt

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

To determine whether the relationship between various measures of left ventricular (LV) contractile state and ejection fraction (EF) is linear in man, we studied 30 patients during right atrial pacing over a range of loading conditions. With the use of micromanometer LV pressures and radionuclide LV volumes, pressure-volume (P-V) loops were generated for each loading condition. Then isochronal, instantaneous P-V data points were obtained by linear regression analysis to attain the maximum slope (Emax) of these time-varying isochrones. Other measures of LV end systole were also used to calculate end-systolic P-V relations in a similar fashion, and indirect P-V relations were obtained from the linear regression analysis of brachial artery peak pressure vs minimum LV volume data points. When the slopes of these LV contractile measures were compared to the radionuclide LV EFs, the linear correlation coefficients ranged from 0.53 to 0.67. After natural log transformation of the LV contractile state and EF data, the correlation coefficients for the polynomial curve fits ranged from 0.80 to 0.88. When the correlation coefficients for the polynomial curve fits of the natural log transformed data were compared to those for the linear regression analyses of the raw data, significant improvements were evident (p < 0.05). Thus the relationship between various measures of LV contractile state and EF obtained with radionuclide angiography is best approximated by a complex, curvilinear relationship that is due, in part, to the wide range of LV contractile states within the relatively narrow normal range of LV ejection fractions.

Original languageEnglish (US)
Pages (from-to)790-798
Number of pages9
JournalAmerican Heart Journal
Volume116
Issue number3
DOIs
StatePublished - 1988

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Radioisotopes
Linear Models
Regression Analysis
Ventricular Pressure
Pressure
Radionuclide Angiography
Brachial Artery
Systole
Patient Rights
Stroke Volume
Reference Values
Blood Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Radionuclide determination of the relationship between left ventricular contractile state and ejection fraction. / Starling, Mark R.; Gross, Milton D.; Walsh, Richard A.; Mancini, G. B John; Blumhardt, Ralph.

In: American Heart Journal, Vol. 116, No. 3, 1988, p. 790-798.

Research output: Contribution to journalArticle

Starling, Mark R. ; Gross, Milton D. ; Walsh, Richard A. ; Mancini, G. B John ; Blumhardt, Ralph. / Radionuclide determination of the relationship between left ventricular contractile state and ejection fraction. In: American Heart Journal. 1988 ; Vol. 116, No. 3. pp. 790-798.
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