NORMALIZATION OF END-SYSTOLIC PRESSURE-VOLUME RELATION AND Emax OF DIFFERENT SIZED HEARTS

Abstract

A shift of the ventricular end-systolic pressure-volume (P-V) relation and a change in its slope Emax reasonably reflect a change in contractility in a given ventricle. However, comparison of Emax's of different sized hearts may be difficult without an appropriate normalization. We attempted to normalize Emax of different sized hearts to the force-length (F-L) relation of unit mass of myocardium in the ventricular wall. We formulated the end-systolic P-V relation as (end-systolic pressure) = Emax (end-systolic volume Vi - Vd), where Vd = volume axis intercept of the end-systolic P-V relation line. As a first step, both thick wall sphere and cylinder models of the ventricle with a wall volume of Vm were used. Circumferential F-L relation of unit myocardium in different ventricular wall layers were formulated as functions of Emax, Vd, and Vm. We found that as long as the product of Emax and F-L relation in the wall remain relatively unchanged regardless of wide changes in Vm and Vi. The elevation of the F-L relation curve, which represents myocardial contractility, was found to change in proportion to Emax Vd, largely independent of Vm and Vi, or the size of the ventricle.