Editorial: The End‐systolic Pressure‐Volume Relation of the Ventricle Definition, Modifications and Clinical Use

BASIC RESEARCH on the ventricular pressure-volume loop diagram has been revived.' Several investigators2-8 proposed that the relationship of end-systolic pressure (or wall stress) to end-systolic volume (or some dimension) may be useful in evaluating the contractile state of the heart. Grossman et al. published an important clinical study" in 1977; many others followed. At the 1980 annual meetings of the American Heart Association and American College of Cardiology, at least 11 papers0-21 were presented concerning the end-systolic relationship between pressure and volume, pressure and thickness, and wall stress and normalized volume. Several significant studies2' 39 have also appeared in the past 5 years; a dozen clinical studies have been published. With this popularity, the original meanings of end-systolic pressure-volume relation and its parameters (e.g., Emax, m, V0 and Vd) have become ambiguous. Sometimes they were purposely modified to attempt to improve their value and other times just to make the measurement easy. Whatever the reasons, it seems appropriate to review these modifications with reference to the proponents' original ideas about fundamental aspects.

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