[How dependable is the end systolic pressure/volume relationship for the determination of left ventricular contractility in aortic valve diseases?].

The validity of the end-systolic pressure/volume ratio (ESP/ESVI) was evaluated in 88 patients with aortic valve disease (31 with aortic stenosis, 28 with aortic insufficiency and 29 with combined valve disease) by comparing the ESP/ESVI ratio with left ventricular systolic function parameters. The results demonstrate that in practice a normal EST/ESVI ratio excludes depression of myocardial contractility. A reduced ESP/ESVI ratio found in 57 patients did, however, correspond to other systolic function parameters indicating depressed or possibly depressed contractility in only 38 patients (66%), whereas biplane left ventricular ejection fraction and the isovolumic velocity indices were normal in 19 patients (33%) - 10 of whom had aortic insufficiency, 8 combined valve disease and only 1 aortic stenosis. It is therefore concluded that the ESP/ESVI ratio is of possible value for the diagnosis of depressed contractility only in patients with aortic stenosis.