Klotz Stefan, Dickstein Marc L, Burkhoff Daniel
Department of Thoracic and Cardiovascular Surgery, University Hospital, Muenster, Germany.
Nat Protoc. 2007;2(9):2152-8. doi: 10.1038/nprot.2007.270.
The end-diastolic pressure-volume relation (EDPVR) is an important descriptor of passive cardiac pump properties. However, clinical utility has been limited by the need for measurement of pressures and volumes over relatively large ranges. In this protocol, we describe an algorithm to estimate the entire EDPVR in humans from a single measured pressure-volume (P-V) point. This algorithm was developed from observations made from accurately measured EDPVRs of human hearts, which indicated that when normalized by appropriate left ventricular volume scaling (to arrive at volume-normalized EDPVRs, EDPVR(n)) EDPVR(n)s were nearly identical in all patients. In this protocol, we demonstrate how to use EDPVR(n)s to predict a second P-V point on the EDPVR, in which case the entire EDPVR can then be predicted. With recent advances for accurate noninvasive measurement of end-diastolic pressure and volumes, this protocol permits the assessment of passive properties in a broader range of research and clinical settings.
舒张末期压力-容积关系(EDPVR)是心脏被动泵血特性的一个重要描述指标。然而,由于需要在相对较大范围内测量压力和容积,其临床应用受到了限制。在本方案中,我们描述了一种算法,可根据单个测量的压力-容积(P-V)点来估计人体的整个EDPVR。该算法是基于对人体心脏精确测量的EDPVR的观察结果开发的,这些观察结果表明,当通过适当的左心室容积缩放进行归一化处理(以得到容积归一化的EDPVR,即EDPVR(n))时,所有患者的EDPVR(n)几乎相同。在本方案中,我们展示了如何使用EDPVR(n)来预测EDPVR上的第二个P-V点,这样就可以预测整个EDPVR。随着近期舒张末期压力和容积精确无创测量技术的进展,本方案允许在更广泛的研究和临床环境中评估被动特性。