A New methodology for non-invasive clinical assessment of cardiovascular system performance and of ventricular-arterial coupling during stress

Erez Nevo, Meir Marmor, Yoram Lanir, Teddy A. Weiss, Alon Marmor

Research output: Contribution to journalArticle

Abstract

The objective of the study was to develop a non-invasive method for the quantitative evaluation of cardiovascular performance and ventricular-arterial (VA) coupling during varying physiological states. VA-coupling was represented by the ratio between the arterial and ventricular elastances - Ea/Ees. Approximate indices of the relative change of Ees and VA-coupling during stress were developed and tested. These indices can be evaluated directly from noninvasive measurements of ejection fraction values (for VA-coupling) and measurements of stroke volumes and systolic and diastolic arterial pressures (for Ees). Additional relative indices can be evaluated from these data (e.g., stroke work, cardiac output) to yield a complete representation of the cardiovascular response to stress. The present methodology was applied to assess the exercise stress response in healthy subjects (H, n = 8) and in patients with left ventricular dysfunction (n = 24). Left ventricular volumes were determined by nuclear angiography and arterial pressures were measured non-invasively by a new, validated method. Using published data obtained invasively, we found that the relative indices of Ees and VA-coupling showed a high correlation with the invasive ones (r > 0.8, P <0.01). The patients were subgrouped by their maximal exercise capacitance (P2 - 50W, P3 - 75W). At rest, the two patient groups had similar ejection fraction values (45 ± 15% and 48 ± 16%), which were significantly different from those of the healthy subjects (66 ± 7%, P <0.05). During stress, a larger increase in stroke work and cardiac output was found in the healthy subjects. All three groups showed similar relative increases in Ees and heart rate, but relative Ea increased in P2 and decreased in H, while the opposite was found for the end-diastolic volume. The relative VA-coupling index in P2 was significantly larger than that in P3 and H (P <0.05). The present non-invasively based indices can be used to quantitatively monitor the individual cardiovascular response to stress testing or drug interventions and to evaluate the importance of VAcoupling in the clinical setting.

Original languageEnglish (US)
Pages (from-to)24-34
Number of pages11
JournalHeart and Vessels
Volume10
Issue number1
DOIs
StatePublished - Jan 1995
Externally publishedYes

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Cardiovascular System
Healthy Volunteers
Cardiac Output
Stroke Volume
Arterial Pressure
Stroke
Exercise
Left Ventricular Dysfunction
Angiography
Heart Rate
Blood Pressure
Pharmaceutical Preparations

Keywords

  • Arterial elastance
  • Exercise stress test
  • Pharmacologic intervention
  • Ventricular end-systolic elastance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

A New methodology for non-invasive clinical assessment of cardiovascular system performance and of ventricular-arterial coupling during stress. / Nevo, Erez; Marmor, Meir; Lanir, Yoram; Weiss, Teddy A.; Marmor, Alon.

In: Heart and Vessels, Vol. 10, No. 1, 01.1995, p. 24-34.

Research output: Contribution to journalArticle

Nevo, Erez ; Marmor, Meir ; Lanir, Yoram ; Weiss, Teddy A. ; Marmor, Alon. / A New methodology for non-invasive clinical assessment of cardiovascular system performance and of ventricular-arterial coupling during stress. In: Heart and Vessels. 1995 ; Vol. 10, No. 1. pp. 24-34.
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