One of the most accurate method to measure ventricular contractility (E_es) and
ID: 178838 • Letter: O
Question
One of the most accurate method to measure ventricular contractility (E_es) and vascular elastance (E_a) is via P-V loop analysis to provide commonly known metric VVCR (ventricular-vascular coupling ratio). A) Read the following article (Truong et al. Journal of Cardiovascular Magnetic Resonance (2015) 17:81) about these variables and compute E_es and E_a using the following instructions and computational method of your choice (Matlab preferably; justify the use of your selected method) Read this article thoroughly! How is the single beat method compared to the non-invasive VVCR metric? How is the non-invasive metric measured? What are benefits and potential problems associated with each method?Explanation / Answer
Ventricular-Vascular Coupling Ratio(VVCR) comprised of effective elastance (Ea, index of arterial load) and right ventricular maximal end-systolic elastance (Ees, index of contractility),is determined by catheterization.But in this article , they used PH as a Non-Invasive Approach to determine the VVCR.
In Single beat method the Ees is calculated using the pressure tracing for a single beat.In this method, the theoretical maximum pressure the ventricle can generate is found by fitting a sinusoid to the isovolumetric regions of the pressure tracing. The maximum of the sinusoid (Pmax) is used with the end-systolic ventricular pressure (Pes) to compute the slope of the end-systolic pressure volume relationship, Ees.
By this Method, Vascular Reactivity can be determined.This method also shows that the single-beat estimation co-relates with the non-invasive VVCR metric.
Benefits of the Non-invasive method :- it avoids exposure to repeated radiations and reduces the risk of exposure to general Anesthesia when compared with the single beat method.
drawbacks of the Non-invasive method :- the non-invasive method may not be accurate at all times, so the single beat method is the preferred method, The Single beat method is cost effective.
Source :- https://jcmr-online.biomedcentral.com/articles/10.1186/s12968-015-0186-1
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