PEAK LEFT-VENTRICULAR SYSTOLIC PRESSURE-END-SYSTOLIC VOLUME RATIO - SENSITIVE DETECTOR OF LEFT-VENTRICULAR DISEASE

The purpose of this study was to evaluate peak pressure systolic volume ratio as a detector of cardiac disease. To validate that tracings obtained through fluid-filled catheters were accurate for this purpose, in 35 patients left ventricular pressure-volume loops were constructed from tracings recorded with a micromanometer-tipped angiographic catheter. Comparisons were made between the peak ratio of left ventricular pressure to volume (Emax) using the micromanometer-tipped angiographic catheter and the ratio between peak left ventricular pressure before angiography and end-systolic volume during angiography ( peak pressure systolic volume ratio) using the fluid-filled lumen of the same catheter. The relations of Emax and that of peak pressure systolic volume ratio to ejection fraction were similar and curvilinear. Peak pressure systolic volume ratio was approximately 10 percent higher than Emax, with a correlation coefficient between 0.99 of the two ratios. Therefore, peak pressure systolic volume ratio, which is easily obtained in clinical practice, can be used instead of Emax. Retrospective analysis of the peak pressure systolic volume ratio and ejection fraction was made from routine diagnostic catheterization data obtained using fluid-filled catheters in 115 subjects, of whom 17 were normal, 60 had coronary artery disease without asynergy, 23 had aortic valve disease and 15 had mitral valve disease. In subjects with a normal ejection fraction (more than 60 percent) the peak pressure systolic volume ratio separated those groups with a diseased heart from those with a normal heart. Those with a diseased heart had a greater end-systolic volume than normal subjects. Thus, the peak pressure systolic volume ratio is more sensitive than ejection fraction in detecting subtle changes in myocardial function in human beings. © 1979.