Single-beat estimation of end-systolic elastance using bilinearly approximated time-varying elastance curve

Although left ventricular end-systolic elastance (E(es)) has often been used as an index of contractility, technical difficulties in measuring volume and in changing loading conditions have made its clinical application somewhat limited. By approximating the time-varying elastance curve by 2 linear functions (isovolumic contraction phase and ejection phase) and estimating the slope ratio of these, we developed a method to estimate E(es) on a single-beat basis from pressure values, systolic time intervals, and stroke volume. In 11 anesthetized dogs, we compared single-beat E(es) with that obtained with caval occlusion. Although the decrease (but not the increase) in contractility (5.3 to 11.4 mm Hg/mL) and the change in loading conditions (3.7 to 34.0 mm Hg/mL) over wide ranges significantly altered the slope ratio, the estimation of E(es) was reasonably accurate (y=0.97 x 0.46, r=0. 929, SEE=2.1 mm Hg/mL). E(es) can be estimated on a single-beat basis from easily obtainable variables by approximating the time-varying elastance curve by a bilinear function.