Multiple-beat and single-beat determination of the ESPDR

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Multiple-beat and single-beat determination of the ESPDR Multiple-beat and single-beat determination of the ESPDR. (A) The single-beat, ESPDR was estimated by fitting points between the peak systolic pressure and the end-systolic points on a steady-state single-loop (open red circles) against (equation (8) in th... Multiple-beat and single-beat determination of the ESPDR. (A) The single-beat, ESPDR was estimated by fitting points between the peak systolic pressure and the end-systolic points on a steady-state single-loop (open red circles) against (equation (8) in the main text) using a non-linear least-square method. While the selection of the end-systolic point influences the estimation of the ESPDR curve and the zero-stress dimension (D0), the zero-stress dimension defines the reference distension to calculate myocardial stiffness and, thus, determines the point that attains maximal stiffness (ie, the end-systolic point). We used an iterative method to determine a combination of the end-systolic point and the zero-stress dimension (D0(SB), which meets the above conditions. (B) Multiple-beat ESPDR (red curve). Points of maximal stress–strain ratio (open red circles) are determined and are fitted against the above equation using a non-linear least-square method, with the use of an iterative method to determine the zero-stress dimension, D0(MB). ESPDR, end-systolic pressure–dimension relationship. Ryo Inuzuka et al. Open Heart 2016;3:e000451 ©2016 by British Cardiovascular Society