Part of Springer Nature

Artery Research

Volume 7, Issue 1, March 2013, Pages 2 - 14

Ventricular–arterial coupling: Invasive and non-invasive assessment

Authors
Julio A. Chirinosa, b, *
aUniversity of Pennsylvania, Philadelphia, PA, USA
bPhiladelphia VA Medical Center, Philadelphia, PA, USA
*University of Pennsylvania and Philadelphia VA Medical Center, Rm 8B111, University and Woodland Avenues, Philadelphia, PA, USA. Tel.: +1 215 200 7779; fax: +1 215 823 5400. E-mail address: Julio.Chirinos@uphs.upenn.edu.
Corresponding Author
Julio A. Chirinos
Available Online 10 January 2013.
DOI
https://doi.org/10.1016/j.artres.2012.12.002How to use a DOI?
Keywords
Ventricular-arterial coupling, Ventricular afterload, Ventricular elastance, Effective arterial elastance
Abstract

Interactions between the left ventricle (LV) and the arterial system, (ventricular–arterial coupling) are key determinants of cardiovascular function. Ventricular–arterial coupling is most frequently assessed in the pressure–volume plane using the ratio of effective arterial elastance (EA) to LV end-systolic elastance (EES). EA (usually interpreted as a lumped index of arterial load) can be computed as end-systolic pressure/stroke volume, whereas EES (a load-independent measure of LV chamber systolic stiffness and contractility) is ideally assessed invasively using data from a family of pressure–volume loops obtained during an acute preload alteration. Single-beat methods have also been proposed, allowing for non-invasive estimations of EES using simple echocardiographic measurements. The EA/EES ratio is useful because it provides information regarding the operating mechanical efficiency and performance of the ventricular–arterial system. However, it should be recognized that analyses in the pressure–volume plane have several limitations and that “ventricular–arterial coupling” encompasses multiple physiologic aspects, many of which are not captured in the pressure–volume plane. Therefore, additional assessments provide important incremental physiologic information about the cardiovascular system and should be more widely used. In particular, it should be recognized that: (1) comprehensive analyses of arterial load are important because EA poorly characterizes pulsatile LV load and does not depend exclusively on arterial properties; (2) The systolic loading sequence, an important aspect of ventricular–arterial coupling, is neglected by pressure–volume analyses, and can profoundly impact LV function, remodeling and progression to heart failure. This brief review summarizes methods for the assessment of ventricular–arterial interactions, as discussed at the Artery 12 meeting (October 2012).

Copyright
© 2013 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

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Journal
Artery Research
Volume-Issue
7 - 1
Pages
2 - 14
Publication Date
2013/01
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
https://doi.org/10.1016/j.artres.2012.12.002How to use a DOI?
Copyright
© 2013 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - Julio A. Chirinos
PY  - 2013
DA  - 2013/01
TI  - Ventricular–arterial coupling: Invasive and non-invasive assessment
JO  - Artery Research
SP  - 2
EP  - 14
VL  - 7
IS  - 1
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2012.12.002
DO  - https://doi.org/10.1016/j.artres.2012.12.002
ID  - Chirinos2013
ER  -