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End-systolic pressure-volume and end-systolic stress-volume relationships in patients with aortic stenosis and with normal valvular function

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Summary

In order to study the effect of left ventricular hypertrophy on the endsystolic pressure-volume relationship, three left ventricular angiograms were performed in ten patients with normal valvular function but with varying left ventricular function (group 1) after 0.15 mg/kg propranolol, and 1 mg atropine: at rest, after isosorbide-dinitrate at a decreased afterload and after methoxamine at an enhanced afterload. In eight patients with aortic stensis (group 2) two left ventricular angiograms were performed: at rest and after isosorbide-dinitrate. Heart rate was kept constant by atrial pacing.

Left ventricular mass in group 1 was 89 g/m2 and in group 2 180 g/m2. In group 1 the slope k of the end-systolic pressure-volume relation was related to the ejection fraction (EF) at rest: k=0.024·e0.072 EF; r=0.93. In group 2 this relation was shifted to the left (P<0.001): k=0.135·e0.057 EF; r=0.81. The relations, however, between the slope k of the end-systolic stress-volume relation and the ejection fraction were close together in group 1 and in group 2 and crossed at an ejection fraction of 67%.

It is concluded: 1. In patients with aortic stenosis the end-systolic pressure-volume relation is steeper than in patients without valvular dysfunction at a given ejection fraction, so the relation between the slope k and the ejection fraction is shifted to the left. 2. The end-systolic stress-volume relationship is not altered in patients with aortic stenosis and seems to be advantageous for the evaluation of left ventricles with substantial hypertrophy due to pressure load.

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Author notes

  1. H. C. Mehmel

    Present address: Med. Univ.-Klinik III (Kardiologie), Bergheimer Str. 58, 6900, Heidelberg, FRG

Authors and Affiliations

  1. Med. Univ.-Klinik III (Kardiologie), Bergheimer Str. 58, 6900, Heidelberg, FRG

    F. Schwarz, K. Ruffmann, J. Manthey, K. von Olshausen & W. Kübler

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  1. H. C. Mehmel
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  2. F. Schwarz
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  3. K. Ruffmann
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  4. J. Manthey
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  5. K. von Olshausen
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  6. W. Kübler
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Additional information

These investigations were supported by a grant from the Bundesministerium für Forschung und Technologie, Grant No. DISMED 18.

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Mehmel, H.C., Schwarz, F., Ruffmann, K. et al. End-systolic pressure-volume and end-systolic stress-volume relationships in patients with aortic stenosis and with normal valvular function. Basic Res Cardiol 78, 338–350 (1983). https://doi.org/10.1007/BF01907442

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  • DOI: https://doi.org/10.1007/BF01907442

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