Systolic Indices of Cardiac Contractility: Modeling and Analysis using Pressure-Volume Loop

Abstract

Modeling cardiac contractility in pre-clinical catheterization laboratory settings remains an important task to collect results under controlled hemodynamic conditions, while providing an assessment of systolic and diastolic indices. Diligent hemodynamic monitoring with acute-based pressure-volume modeling uncovers early indicators of heart failure (HF). In this article, basic procedural assessments are outlined, while deeper dive into systolic index of contractility, the end systolic elastance is provided with references to older, while comparing it to novel approaches. Transient preload reduction using inferior vena cava occlusion (IVCO) is the current standardized maneuver used in hemodynamic protocols to provide an assessment of contractile responsiveness. In this article an example of standard measures from a single catheterization lab were depicted using tables and figures, giving background to transient preload reduction to assess the values of systolic cardiac contractility. Additionally, novel twists on other possible index(ices) coming from capturing ES point may well present future opportunities to collect systolic cardiac contractility. In this instance, both single beat systolic PPESPVR and IVCO using ES points present unique opportunities in this niche area of research. Final two sections of this article are dedicated to procedural steps and how to standardize execution of IVCO. Final section is reserved for analytical steps of how to visually compare systolic indices post-IVCO in case of linear and quadratic relationship.