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Table 1 Force-frequency relationship from the experimental lab to clinical applications

From: Myocardial contractility in the echo lab: molecular, cellular and pathophysiological basis

Author

Feldman

Bhargava

Hasenfusss

Liu

Inagaki

Schuler

Dehmer

Lavie

Journal

J Clin Invest

Am J Cardiol

Eur Heart J

Circ

Circ

Am j Cardiol

Am J Cardiol

Chest

Year

1988

1988

1994

1993

1999

1982

1981

1989

Method

cath lab

cath lab

cath lab

cath lab

cath lab

nuc

nuc

nuc

FORCE

SP/ESV

dP/dt

dP/dt

Ees

dP/dt

SP/ESV

SP/ESV

SP/ESV

TREPPE

Yes

Yes

Yes

Yes

Yes

Base- peak

Base-peak

Base-peak

HR increase

PM

PM

PM

PM

PM

EX

ISO

EX

EX

EX

PTS# Disease

DC 7

DC 5

DC 9

HYP 10

HYP 17

AR 14

AR 17

MR 11

FFR Upsloping

3

-

-

-

7

7

11

7

   Flat-Biph

-

2

-

10

10

7

2

2

   Neg

4

3

9

-

-

-

4

2

Control #

6

3

8

8

10

9

15

-

FFR Upsloping

6

3

8

8

10

9

15

-

   Flat-Biph

-

-

-

-

-

-

-

-

   Neg

-

-

-

-

-

-

-

-

  1. PM = atrial pacing; EX = exercise; ISO = isoproterenol ; DC = dilated cardiomyopathy; HYP = hypertensive cardiomyopathy; CHD = coronary artery disease; AR = aortic regurgitation; MR = mitral regurgitation; FFR = force-frequency relation
  2. Several attempts have been made to transfer the force-frequency relationship from the experimental lab to clinical applications. Such attempts have been based on invasive evaluation in cath lab (Feldman 1988, Bhargava 1988, Hasenfuss 1994, Liu 1993, Inagaki 1999), or noninvasive evaluation with radionuclide scintigraphy (Schuler 1982, Dehmer 1981, Lavie 1989). The extensively adopted maximum rate of pressure rise (max dP/dt) for force measurement is largely preload and afterload dependent. Since End-systolic elastance (Ees), is almost insensitive to changes in preload and afterload, Ees should be measured at each heart rate step increase, as done by Liu and coworkers.
  3. But measuring Ees for increasing heart rates is impractical: increasing heart rates obtained with atrial pacing has to be adjunct to the LV conductance catheter, the LV pressure catheter, the vena cava balloon, and the afterload changes. Proof of this is that only Liu adopted this method in humans.
  4. The scintigraphic approach is noninvasive, but requires exposure to ionizing radiations and – due to limited temporal resolution – allows the measurement of SP/ESV only at baseline at peak exercise. The pattern of the force-frequency relationship over a spectrum of different heart rates cannot be assessed.