Noninvasive assessment of left ventricular contractility by pacemaker stress echocardiography

Tonino Bombardini, Marco Agrusta, Nino Natsvlishvili, Francesco Solimene, Robert Pap, Fernando Coltorti, A. Varga, Gaetano Mottola, Eugenio Picano

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Estimating contractility of the left ventricle with noninvasive techniques is an important yet elusive goal. Positive inotropic interventions are mirrored by smaller end-systolic volumes and higher end-systolic pressures. An increased heart rate progressively increases the force of ventricular contraction (Bowditch treppe or staircase phenomenon). Aim: To assess the feasibility of a noninvasive estimation of force-frequency relation (FFR) during pacing stress in the echo lab in patients with permanent pacemaker (PM). Methods: Transthoracic stress pacing echocardiography was performed in 26 patients with a permanent pacemaker (age 69±11 years; 21 men, 5 women). Seven patients had normal function at baseline and during stress ("normals"); eight had angiographically assessed coronary artery disease (three with and five without induced ischemia with stress echo); eleven patients had dilated cardiomyopathy (DC). To build the FFR, the force was determined at different steps as the ratio of the systolic pressure (SP, cuff sphygmomanometer)/end-systolic volume index (ESV, biplane Simpson rule/body surface area). Heart rate was determined from ECG. Results: The absolute value of the FFR slope was highest in controls and lowest in DC patients. A flat-downsloping FFR was found in 12/19 patients but not for normals (p

Original languageEnglish
Pages (from-to)173-181
Number of pages9
JournalEuropean Journal of Heart Failure
Volume7
Issue number2
DOIs
Publication statusPublished - Mar 2 2005

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Stress Echocardiography
Dilated Cardiomyopathy
Heart Rate
Sphygmomanometers
Blood Pressure
Body Surface Area
Heart Ventricles
Coronary Artery Disease
Electrocardiography
Ischemia

Keywords

  • Bowditch treppe
  • Force-frequency relationship
  • Heart failure
  • Pacemaker stress echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bombardini, T., Agrusta, M., Natsvlishvili, N., Solimene, F., Pap, R., Coltorti, F., ... Picano, E. (2005). Noninvasive assessment of left ventricular contractility by pacemaker stress echocardiography. European Journal of Heart Failure, 7(2), 173-181. https://doi.org/10.1016/j.ejheart.2004.04.019

Noninvasive assessment of left ventricular contractility by pacemaker stress echocardiography. / Bombardini, Tonino; Agrusta, Marco; Natsvlishvili, Nino; Solimene, Francesco; Pap, Robert; Coltorti, Fernando; Varga, A.; Mottola, Gaetano; Picano, Eugenio.

In: European Journal of Heart Failure, Vol. 7, No. 2, 02.03.2005, p. 173-181.

Research output: Contribution to journalArticle

Bombardini, T, Agrusta, M, Natsvlishvili, N, Solimene, F, Pap, R, Coltorti, F, Varga, A, Mottola, G & Picano, E 2005, 'Noninvasive assessment of left ventricular contractility by pacemaker stress echocardiography', European Journal of Heart Failure, vol. 7, no. 2, pp. 173-181. https://doi.org/10.1016/j.ejheart.2004.04.019
Bombardini, Tonino ; Agrusta, Marco ; Natsvlishvili, Nino ; Solimene, Francesco ; Pap, Robert ; Coltorti, Fernando ; Varga, A. ; Mottola, Gaetano ; Picano, Eugenio. / Noninvasive assessment of left ventricular contractility by pacemaker stress echocardiography. In: European Journal of Heart Failure. 2005 ; Vol. 7, No. 2. pp. 173-181.
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