Send to

Choose Destination
See comment in PubMed Commons below
Int J Cardiol. 1991 Apr;31(1):51-8.

Ventricular-load optimization by inotropic stimulation in patients with heart failure.

Author information

Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.


To evaluate the effects of inotropic stimulation on ventriculo-arterial coupling, we determined both the slope of the end-systolic pressure-volume relationship (ventricular elastance) and the slope of end-systolic pressure-stroke volume relationship (arterial elastance) at rest and during dobutamine infusion (5 micrograms/kg/min). We also determined stroke work, end-systolic potential energy and the ventricular work efficiency defined as stroke work per pressure volume area (stroke work + potential energy). In the resting state, ventricular elastance was lower than arterial elastance and work efficiency was about 59.7 +/- 9.3% (mean +/- SD). This condition is remote from the point where stroke work or mechanical efficiency is optimal. Enhanced ventricular elastance by 41% with dobutamine resulted in a significant reduction in both left ventricular end-diastolic and end-systolic volumes and was accompanied by the reduction in arterial elastance by 23%. Consequently, the ratio of arterial elastance to ventricular elastance decreased from 1.43 +/- 0.57 to 0.82 +/- 0.47, which resulted in an increase in stroke work, a decrease in potential energy and hence a marked increase in work efficiency. Thus, inotropic stimulation of depressed hearts could modulate ventriculo-arterial coupling towards optimization of either stroke work or mechanical efficiency.

[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Loading ...
    Support Center