Document Detail

Noninvasive evaluation of left ventricular afterload: part 1: pressure and flow measurements and basic principles of wave conduction and reflection.
MedLine Citation:
PMID:  20733089     Owner:  NLM     Status:  MEDLINE    
The mechanical load imposed by the systemic circulation to the left ventricle is an important determinant of normal and abnormal cardiovascular function. Left ventricular afterload is determined by complex time-varying phenomena, which affect pressure and flow patterns generated by the pumping ventricle and cannot be expressed as a single numeric measure or described in terms of pressure alone. Left ventricular afterload is best described in terms of pressure-flow relations. High-fidelity arterial applanation tonometry can be used to record time-resolved central pressure noninvasively, whereas contemporary noninvasive imaging techniques, such as Doppler echocardiography and phase-contrast MRI, allow for accurate assessments of aortic flow. Central pressure and flow can be analyzed using simplified biomechanical models to characterize various components of afterload, with great potential for mechanistic understanding of the role of central hemodynamics in cardiovascular disease and the effects of therapeutic interventions. In the first part of this tutorial, we review noninvasive techniques for central pressure and flow measurements and basic concepts of wave conduction and reflection as they relate to the interpretation of central pressure-flow relations. Conceptual descriptions of various models and methods are emphasized over mathematical ones. Our review is aimed at helping researchers and clinicians apply and interpret results obtained from analyses of left ventricular afterload in clinical and epidemiological settings.
Julio A Chirinos; Patrick Segers
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-08-23
Journal Detail:
Title:  Hypertension     Volume:  56     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  555-62     Citation Subset:  IM    
Department of Medicine, Philadelphia Veterans' Affairs Medical Center-University of Pennsylvania, Philadelphia, Pa, USA.
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MeSH Terms
Blood Flow Velocity / physiology
Blood Pressure / physiology*
Echocardiography, Doppler / methods*
Heart Conduction System / physiology*
Hemodynamics / physiology
Models, Biological
Pulsatile Flow / physiology
Ventricular Function, Left / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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