Blood Pressure-flow Loop invasive left ventricular pressure and aortic blood flow (part 2) Filip Konecny The invasive left ventricular pressure, aortic blood flow relationship during baseline & under Dobutamine stress challenge in large animal model

Overview Left ventricular pressure plotted versus the Aortic blood flow; data collected during baselines (200 samples/sec) Utilizing max dp/dt and the Aortic pressure notch (the end systole) as description of the LV Ejection phase One cardiac cycle composed from pressure vs. Ao blood flow creating pressure flow loop on the right Ejection phase of pressure-flow loop from blue triangle to blue square with its path shown as a square dotted line Left ventricular Pressure trace (mmHg) Aortic blood pressure trace (mmHg) Aortic blood flow (l/min) dp/dt (mmHg/s) 2

Data collected during Baseline Using LVP vs. Ao Blood flow traces, selected is the LV ejection on the LVP (using max and min dp/dt). One ejection cycle’s mean dV/dt shown in red circle as an individual dV/dt (ml/min/s). Final Table 1 at slide 5 shows 10 dv/dt (SV) during consecutive ejection cycles Left ventricular pressure trace (mmHg) Aortic blood flow (l/min) dp/dt (mmHg/s)

Data collected during Dobutamine stress at (5µg/kg/min) Using LVP vs. Ao Blood flow traces, selected is the LV ejection on the LVP (using max and min dp/dt). One ejection cycle’s mean dV/dt shown in red circle as an individual dV/dt (ml/min/s). Final Table 1 at slide 5 shows 10 dv/dt (SV) during consecutive ejection cycles Left ventricular pressure trace (mmHg) Aortic blood flow (l/min) dp/dt (mmHg/s)

Cardiac Ejection BSL Mean dV/dt BSL dp/dt max BSL dp/dt min DOBU Mean dV/dt DOBU dp/dt max DOBU dp/dt min Ejection 1 8.118 1341 1318 12.012 3648 1798 Ejection 2 6.505 1316 1405 12.245 3661 2087 Ejection 3 7.548 1322 1445 12.49 3636 1773 Ejection 4 10.923 1308 1238 13.639 3595 1865 Ejection 5 10.32 1337 1288 13.444 3665 1674 Ejection 6 11.117 1194 1213 11.624 3606 1850 Ejection 7 11.652 1242 1270 13.827 3641 1887 Ejection 8 10.667 1124 1173 12.145 1904 Ejection 9 7.221 1162 1263 12.281 3416 1881 Ejection 10 6.029 1261 1284 10.582 3732 2199 Mean 9.010 1260.700 1289.700 12.429 3626.500 1891.800 SD 2.1 77.9 82.7 1.0 82.8 151.1 Mean HR 114 bpm 155 bpm T test 0.00052409 7.75652E-23 2.77858E-08 Table 1 captures mean dV/dt during ejection time (ET) selected by dp/dt data from Baseline and Dobutamine 5µg/kg. Data are taken from 10 consecutive cardiac beats at specified HR, T test results are shown below the table.

Phases of Ao Blood flow wave at (baseline) Isovolumic Contraction time (IVCT) Ejection time (ET) From the R-wave on ECG to dp/dt max (IVCT)…..30 msec From the dpdt max to dpdt min (ET)…..180 msec Isovolumic Relaxation time (IVRT) and Filling time From the dpdt min to R wave (IVRT)….320 msec

Phases of Ao Blood flow wave DURING (DOBU) Dobutamine 5µg/kg Phases of Ao Blood flow wave DURING (DOBU) Isovolumic Contraction time (IVCT) Ejection time (ET) From the R-wave on ECG to dp/dt max (IVCT)…..10 msec From the dpdt max to dpdt min (ET)…..150 msec Isovolumic Relaxation time (IVRT) and Filling time From the dpdt min to R wave (IVRT)….360 msec

BSL Dobutamine Cardiac Cycle IVCT (msec) ET (msec) IVRT+ fill (msec) Cycle 1 30 200 310 10 165 355 Cycle 2 190 320 15 150 360 Cycle 3 35 315 365 Cycle 4 175 325 Cycle 5 185 Cycle 6 330 145 370 Cycle 7 180 Cycle 8 195 155 Cycle 9 160 350 Cycle 10 Mean 32 187 317 11 154 361 SD 2.4 8.2 6.7 2.1 7.5 6.1 Mean HR 118 bpm 160 bpm T test 1.14896E-13 2.0331E-08 1.1302E-11 Table 2 captures cardiac cycle intervals IVCT, ET and IVRT+fill time; data are from Baseline and Dobutamine 5µg/kg; taken from 10 consecutive cardiac cycles at specified HR, T test results are shown below the table.