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
| - | - | - | - | - | - | - | - |
- 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
- 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.
- 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.
- 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.