End-systolic Pressure–Volume Relation, Ejection Fraction, and Heart Failure: Theoretical Aspect and Clinical Applications

A mathematical formalism describing the nonlinear end-systolic pressure–volume relation (ESPVR) is used to derive new indexes that can be used to assess the performance of the heart left ventricle by using the areas under the ESPVR (units of energy), the ordinates of the ESPVR (units of pressure), o...

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Main Author: Rachad M. Shoucri
Format: Article
Language:English
Published: SAGE Publishing 2015-01-01
Series:Clinical Medicine Insights: Cardiology
Online Access:https://doi.org/10.4137/CMC.S18740
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spelling doaj-6f516b40c3e746aaa04168b71a13c7dc2020-11-25T02:54:19ZengSAGE PublishingClinical Medicine Insights: Cardiology1179-54682015-01-019s110.4137/CMC.S18740End-systolic Pressure–Volume Relation, Ejection Fraction, and Heart Failure: Theoretical Aspect and Clinical ApplicationsRachad M. Shoucri0Department of Mathematics and Computer Science, Royal Military College of Canada, Kingston, Ontario, Canada.A mathematical formalism describing the nonlinear end-systolic pressure–volume relation (ESPVR) is used to derive new indexes that can be used to assess the performance of the heart left ventricle by using the areas under the ESPVR (units of energy), the ordinates of the ESPVR (units of pressure), or from slopes of the curvilinear ESPVR. New relations between the ejection fraction (EF) and the parameters describing the ESPVR give some insight into the problem of heart failure (HF) with normal or preserved ejection fraction. Relations between percentage occurrence of HF and indexes derived from the ESPVR are also discussed. When ratios of pressures are used, calculation can be done in a noninvasive way with the possibility of interesting applications in routine clinical work. Applications to five groups of clinical data are given and discussed (normal group, aortic stenosis, aortic valvular regurgitation, mitral valvular regurgitation, miscellaneous cardiomyopathies). No one index allows a perfect segregation between all clinical groups, it is shown that appropriate use of two indexes (bivariate analysis) can lead to better separation of different clinical groups.https://doi.org/10.4137/CMC.S18740
collection DOAJ
language English
format Article
sources DOAJ
author Rachad M. Shoucri
spellingShingle Rachad M. Shoucri
End-systolic Pressure–Volume Relation, Ejection Fraction, and Heart Failure: Theoretical Aspect and Clinical Applications
Clinical Medicine Insights: Cardiology
author_facet Rachad M. Shoucri
author_sort Rachad M. Shoucri
title End-systolic Pressure–Volume Relation, Ejection Fraction, and Heart Failure: Theoretical Aspect and Clinical Applications
title_short End-systolic Pressure–Volume Relation, Ejection Fraction, and Heart Failure: Theoretical Aspect and Clinical Applications
title_full End-systolic Pressure–Volume Relation, Ejection Fraction, and Heart Failure: Theoretical Aspect and Clinical Applications
title_fullStr End-systolic Pressure–Volume Relation, Ejection Fraction, and Heart Failure: Theoretical Aspect and Clinical Applications
title_full_unstemmed End-systolic Pressure–Volume Relation, Ejection Fraction, and Heart Failure: Theoretical Aspect and Clinical Applications
title_sort end-systolic pressure–volume relation, ejection fraction, and heart failure: theoretical aspect and clinical applications
publisher SAGE Publishing
series Clinical Medicine Insights: Cardiology
issn 1179-5468
publishDate 2015-01-01
description A mathematical formalism describing the nonlinear end-systolic pressure–volume relation (ESPVR) is used to derive new indexes that can be used to assess the performance of the heart left ventricle by using the areas under the ESPVR (units of energy), the ordinates of the ESPVR (units of pressure), or from slopes of the curvilinear ESPVR. New relations between the ejection fraction (EF) and the parameters describing the ESPVR give some insight into the problem of heart failure (HF) with normal or preserved ejection fraction. Relations between percentage occurrence of HF and indexes derived from the ESPVR are also discussed. When ratios of pressures are used, calculation can be done in a noninvasive way with the possibility of interesting applications in routine clinical work. Applications to five groups of clinical data are given and discussed (normal group, aortic stenosis, aortic valvular regurgitation, mitral valvular regurgitation, miscellaneous cardiomyopathies). No one index allows a perfect segregation between all clinical groups, it is shown that appropriate use of two indexes (bivariate analysis) can lead to better separation of different clinical groups.
url https://doi.org/10.4137/CMC.S18740
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