PV Loops in Action CHF 2025.pptx

1、Ryan J.Tedford,MD,FACC,FAHA,FHFSAPeter C.Gazes Endowed Chair and Professor of Medicine,Section Chief,Heart FailureMedical Director,Cardiac TransplantMedical University of South Carolina,Charleston,SC,PV Loops In ActionChicago Hemodynamics Forum 2025,November 14,2025,RyanTedfordMD,Disclosures of Conf

2、lict of Interest,Consultant Abbott,Acorai,Adona,Aria CV Inc.,Alleviant,Boston Scientific,Edwards LifeSciences,Endotronix,Fauna Bio,Gradient,Imbria,Medtronic,Merck,Morphic Therapeutics,Pulmovant,Tempus AI,35Pharma,United Therapeutics.Steering Committees Abbott,Edwards LifeSciences,Endotronix,Merck,Re

3、store Medical,Tempus AIHemodynamic Core Lab-Merck Research Advisory Group-Abiomed,Ryan J.Tedford,MD,One more disclosure,I PV Loops!,The Pressure Volume Loop A Single Cardiac Cycle,Pressure(mmHg),AV/PV opens,AV/PV closes(onset of diastole),MV/TV closes(onset of systole),MV/TV opens,Preload(RV/LVEDV),

4、Stroke Volume,Contractility,60,80,100,120,0,10,20,30,40,50,Volume(mL),0,20,40,140,Pressure(mmHg),End Systolic Elastance(EES),Relatively load independent measure of contractility,End systolic pressure,Preload reduction,The elastic ventricle stiffens(and relaxes)along a predictable time course during

5、the cardiac cycle,The maximal ratio of pressure and volume is determined for each loop(end-systolic points),A bit of history:Contractility on the PV loop(End-systolic elastance),Suga H et al.Circ Res.1973Mar;32(3):314-22.,Preload insensitivityInotropic sensitivity,Contractility on the PV loop(End-sy

6、stolic elastance),Maughan WL et al.Circ Res 54:595-602,1984.,Acute Afterload insensitivity,The First RV Pressure Volume Loop,Circ Res.1979;44:309-315,Dashed=Epi,B=Baseline,D=Dobutamine,E=Esmolol,RV PV Loop Changes Shape in PH,Richter MJ et al.AJP LCMP 2021,How are they generated?,Conductance Cathete