Asymptotic slope of log pressure vs log volume as an approximate index of the diastolic elastic properties of the myocardium in man

Abstract

The goal of this study was to develop, on a rational basis, an index of the intrinsic diastolic elastic properties of the left ventricle. A relatively simple analytic model employing a thin walled spherical geometry, coupled with an approximate formulation of a two dimensional constructive relation, was used to examine the primary determinants of the pressure volume relationship of the intact heart. The results permit comparison with other indices of compliance or wall stiffness. The slope of the dP/dV vs P curve was found to be sensitive to the non linear elastic constant K, but is also sensitive to variations in cardiac muscle volume. VdP/dV was found to be sensitive to pressure. m=d(log P)/d(log V)=(V/P)(dP/dV) is proposed as an index sensitive to K and relatively insensitive to both pressure and initial cardiac geometry. The index is compared with published studies. Using the data of Fester and Samet, mean values of the asymptotic log log P V slope, m, evaluated at end diastole for normal, idiopathic hypertrophy, mild, moderate and severe coronary artery disease were 3.95 ± 0.60 (SEM), 5.05 ± 1.60, 5.24 ± 0.96, 8.35 ± 2.06, and 15.13 ± 3.0, respectively. At values of LVEDP less than 7 mm Hg the concept of simple distension is questioned. The advantages and limitations of this approximate index are discussed. This index seems to afford a practical measure of the elastic properties of the wall over a rather wide range of pressure, volume, wall mass and wall thickness.