Document Detail

Assessment of left ventricular end-systolic pressure-volume relations with an impedance catheter and transient inferior vena cava occlusion: use of this system in the evaluation of the cardiotonic effects of dobutamine, milrinone, Posicor and epinephrine.
MedLine Citation:
PMID:  3760389     Owner:  NLM     Status:  MEDLINE    
The end-systolic pressure-volume relation has been postulated as a load-independent measure of cardiac contractility, but has been difficult to measure because of technical problems associated with the serial measurement of intracardiac volume over a physiologic range of ventricular loading conditions. Utilizing a multielectrode impedance catheter to assess continuous, on-line left ventricular relative volume during transient inferior vena cava occlusion, a method is described for determining the end-systolic pressure-volume relation and for assessing changes in this relation secondary to inotropic modulation. In particular, using this method, the relative inotropic properties were determined of four drugs: dobutamine, milrinone, epinephrine and an experimental cardiotonic agent (Ro 13-6438, Posicor). Left ventricular micromanometer pressure and impedance catheter volume were measured continuously in 10 open chest, anesthetized dogs and 14 pigs. Arterial pressure was altered over a range of 20 to 60 mm Hg by brief inferior vena cava constriction. A linear end-systolic pressure-volume relation was observed in pressure-volume diagrams constructed from on-line pressure and impedance catheter recordings. Administration of dobutamine, milrinone and epinephrine resulted in a leftward shift and an increase in the slope of the end-systolic pressure-volume relation as compared with baseline; Posicor did not alter the slope over a range of doses, despite an increase in the cardiac output secondary to arterial vasodilation. Volume changes as measured by the impedance method closely paralleled simultaneous changes in the ultrasonic crystal-determined segment length, and the impedance end-systolic pressure-volume relation slope was reproducible with repeated load-altering maneuvers.(ABSTRACT TRUNCATED AT 250 WORDS)
R G McKay; M J Miller; J J Ferguson; S Momomura; P Sahagian; W Grossman; R C Pasternak
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  8     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1986 Nov 
Date Detail:
Created Date:  1986-11-20     Completed Date:  1986-11-20     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1152-60     Citation Subset:  AIM; IM    
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MeSH Terms
Blood Pressure / drug effects
Cardiography, Impedance
Cardiotonic Agents / pharmacology*
Dobutamine / pharmacology*
Drug Evaluation, Preclinical
Epinephrine / pharmacology*
Heart Rate / drug effects
Myocardial Contraction / drug effects*
Pyridones / pharmacology*
Quinazolines / pharmacology*
Stroke Volume / drug effects*
Vena Cava, Inferior
Grant Support
Reg. No./Substance:
0/Cardiotonic Agents; 0/Pyridones; 0/Quinazolines; 34368-04-2/Dobutamine; 51-43-4/Epinephrine; 70018-51-8/quazinone; 78415-72-2/Milrinone

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