Correction for preload in assessment of myocardial contractility in aortic and XXXX . Application of the concept of systolic @entity296 .

@entity1 @entity296 @entity339 @entity29817 @entity337 @entity955 @entity123 @entity472 @entity1673 @entity65
With single-beat analysis, the new concept of systolic @entity296 is applied to provide a new approach for the assessment of myocardial contractility in aortic and @entity339 . Seventy @entity1 underwent diagnostic right and left heart catheterization. Twenty-six @entity1 had @entity472 , 18 had @entity337 , and 26 had @entity339 . @entity1 with @entity472 were divided into two groups on the basis of left ventricular mass index less than 172 g/m2 ( @entity1673 ) and mass index greater than or equal to 172 g/m2 (AS2). The @entity339 @entity1 were divided into those in normal sinus rhythm ( @entity29817 ) and those in @entity955 (MR2). Nine @entity1 without significant @entity65 served as controls. Thirteen @entity1 with @entity472 and eight with @entity337 were evaluated (average, approximately 18 months) after successful aortic valve replacement. With simultaneous left ventricular pressure and cineangiographic methods, myocardial contractility was assessed by the conventional ejection fraction-afterload relation (uncorrected for preload) and by two new methods that permit the correction of the ejection fraction for preload. Assessments of the contractile state by these two new methods differed from those by the conventional method in 20-40% of the cases studied. Contractile state improved postoperatively in @entity472 and @entity337 even in @entity1 with preoperative depressed contractile states. In @entity1 with @entity339 , there was considerable heterogeneity of contractile function preoperatively. Severe left @entity123 in @entity472 was not a marker for postoperative outcome since contractility was normal postoperatively in @entity1673 and AS2 in equal numbers. This study demonstrates that preload correction is important in a preoperative assessment of contractility in aortic and @entity339 but that it is less important postoperatively, presumably because of reductions in the preload.
