Systolic and diastolic pressure-volume relationships during cardiac surgery

• Published in: Journal of cardiothoracic and vascular anesthesia Vol. 5; no. 6; pp. 539 - 545
• Main Authors: Schreuder, Jan J., Biervliet, Jules D., van der Velde, Enno T., ten Have, Klaas, van Dijk, Arjan D., Meyne, Nico G., Baan, Jan
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.12.1991; Elsevier
• Subjects: Aged; Biological and medical sciences; Blood Pressure - physiology; Coronary Artery Bypass; Humans; Male; Medical sciences; Middle Aged; Monitoring, Intraoperative - methods; Stroke Volume - physiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Ventricular Function, Left - physiology; Human; Systolic pressure; Diastolic pressure; Aortocoronary; Bypass; Surgery; Cardiovascular disease; Left ventricle performance; Coronary heart disease
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1016/1053-0770(91)90002-B

Seven patients undergoing elective coronary artery bypass surgery were studied to assess left ventricular (LV) performance by pressure-volume loops. LV pressure was measured by micromanometry and instantaneous LV volume by a conductance catheter. Continuous pressure-volume relationships were determined during preload reduction before and after cardiopulmonary bypass (CPB). End-systolic elastance (E es), as the slope of the end-systolic pressure-volume relationship (ESPVR), and diastolic elastance (E d) were calculated from these interventions. Changes in position of the E es were assessed at V 75, the value of LV end-systolic volume at 75 mm Hg of LV pressure. From pre-CPB to post-CPB, E es increased in three patients with a decrease of V 75 in two patients, and E es, decreased in four patients with a concomitant increase in V 75. E d increased significantly ( P < 0.01) following CPB, demonstrating a decrease of ventricular distensibility. It is concluded that continuous measurement of LV pressure-volume relationships using the conductance catheter is feasible and may be a useful tool to estimate LV performance during cardiac surgery.