Time to dP/dt(max), a useful index for evaluation of contractility in the catheterization laboratory

David Adler, E. Scott Monrad, Otto M. Hess, Hans P. Krayenbuehl, Edmund H. Sonnenblick

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Hypothesis: The time from onset of contraction to dP/dt(max), td, is suggested as an index of contractility in the catheterization laboratory. Methods: We studied 22 normal patients and 18 patients with myocardial failure in the catheterization laboratory. The two groups were completely separated on the t(d)-heart rate (HR) plane. In the normal patients. HR = 73 ± 19 beats/min, t(d) = 73 ± 11 ms, and an inverse linear relation t(d) = 109-0.49 X HR (p<0.001) exist. In the patients with myocardial failure, despite significantly higher HR than in normal patients (HR = 93 ± 14 beat/min) (p < 0.001 t(d) to paradoxically increased (t(d) = 89 ±11 ms, p<0.0001). Conclusions: These findings support a mathematical analysis of the left ventricular pressure (LVP) during isovolumic contraction in the time domain which shows that to and (dP/dt)/P reflect the time-dependent aspects of contraction and, hence, decrease with increasing contractility. This study shows that t(d), at any given HR, is a reliable index of contractility. Thus, a ready-to-use t(d)-HR plot containing a well-based separation line can provide a reliable and simple method for determining contractility in the catheterization laboratory by examining whether a patient's to value at any HR is below (normal) or above (impaired contractility) the separation line.

Original languageEnglish (US)
Pages (from-to)397-403
Number of pages7
JournalClinical Cardiology
Volume19
Issue number5
StatePublished - May 1996

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Catheterization
Heart Rate
Heart Failure
Ventricular Pressure

Keywords

  • cardiac catheterization
  • cardiac inotropism
  • heart contractility
  • left ventricular function
  • myocardial contraction
  • myocardial diseases

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Adler, D., Monrad, E. S., Hess, O. M., Krayenbuehl, H. P., & Sonnenblick, E. H. (1996). Time to dP/dt(max), a useful index for evaluation of contractility in the catheterization laboratory. Clinical Cardiology, 19(5), 397-403.

Time to dP/dt(max), a useful index for evaluation of contractility in the catheterization laboratory. / Adler, David; Monrad, E. Scott; Hess, Otto M.; Krayenbuehl, Hans P.; Sonnenblick, Edmund H.

In: Clinical Cardiology, Vol. 19, No. 5, 05.1996, p. 397-403.

Research output: Contribution to journalArticle

Adler, D, Monrad, ES, Hess, OM, Krayenbuehl, HP & Sonnenblick, EH 1996, 'Time to dP/dt(max), a useful index for evaluation of contractility in the catheterization laboratory', Clinical Cardiology, vol. 19, no. 5, pp. 397-403.
Adler, David ; Monrad, E. Scott ; Hess, Otto M. ; Krayenbuehl, Hans P. ; Sonnenblick, Edmund H. / Time to dP/dt(max), a useful index for evaluation of contractility in the catheterization laboratory. In: Clinical Cardiology. 1996 ; Vol. 19, No. 5. pp. 397-403.
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