Figure 1
Figure 2
![Pressure-volume analyses demonstrating the normal PV loop (PVL) and the determinants of ventricular function, including the ESPVR (characterized by the slope [Ees] and the volume axis intercept [V0] and the EDPVR. Shifts in the ESPVR are often equated with changes in inotropic state (rightward shift with decreased LVEF), while remodelling with increased valumes shifts the EDPVR. Stroke volume is EDV - ESV; SW is the PVL area, which multiplied by heart rate results in cardiac power.Ea, effective arterial elastance; EDPVR, end-diastolic pressure–volume relationship; EDPVR, end diastolic pressure volume relation, Ees, end-systolic elastance; ESPVR, end-systolic pressure–volume relationship; V0, volume at a Pes of 0 mmHg. SV, Stroke volume; EDV, end-diastolic volume; ESV, end-systolic volume; SW, stroke work.](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/647364834e662f30ba53c5bf/j_rjc.2021.31.2.351_fig_002.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20251205%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251205T162935Z&X-Amz-Expires=3600&X-Amz-Signature=a72e0b5691694f515d9a5cb37242ba3df8aba3c4b5e87de99a2674f5add4c35b&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Figure 3
Figure 4
Correlation analysis between LV ejection fraction (LVEF) and hemodynamic variables in advanced HF patients
| Ea | Ees | VAC | LV Force | ||
|---|---|---|---|---|---|
| LVEF | r | −.434 | −.225 | −.324 | .405 |
| p | .072 | .370 | .190 | .119 |
Demographic and clinical data in advanced (stage D) HF patients compared to asymptomatic ‘pre-HF’ (stage B) patients
| Variable | adavanced HF patients (n=18) | ‘pre-HF’ patients (n=12) | p value |
|---|---|---|---|
| Age (y) | 59+/−9,3 | 56+/−13,8 | 0.48 |
| Males (%) | 100 (n=18) | 77 (n=8) | 0.018 |
| BSA (mean) | 1,97+/−0,14 | 1,91+/−0,19 | 0.32 |
| Hemoglobin g/dl (mean) | 13,1+/−1,7 | 13,6+/−0,9 | 0.5 |
| Hypertension (%) | 77 (n=14) | 83 (n=10) | 1 |
| Diabetes mellitus (%) | 44 (n=8) | 25 (n=3) | 0.44 |
| Chronic kidney disease (%) | 66 (n=12) | 17 (n=2) | 0.010 |
| Ischemic etiology (%) | 39 (n=7) | 58 (n=7) | 0.457 |
| Prolonged QRS (%) | 28 (n=5) | 0 | 0.0657 |
| Left bundle branch block (%) | 16 (n=3) | 0 | 0.252 |
| ACEI (%) | 44 (n=8) | 50 (n=6) | 1 |
| ARNI (%) | 33 (n=6) | 17 (n=2) | 0.419 |
| BB (%) | 83 (n=15) | 66 (n=8) | 0.3915 |
| Pulse pressure (mean) | 42+/−16 | 58+/−11 | 0.0054 |
Comparison of basic echocardiographic parameters of the studied groups
| Variable | advanced HF patients (n=18) | ‘pre-HF’ patients (n=12) | p value |
|---|---|---|---|
| EDV End-diastolic diameter | 67+/−6.8 | 49+/−7.7 | 0.0001 |
| ESV End-systolic diameter | 62+/−5.9 | 35+/−8.3 | 0.0001 |
| LVMi Indexed left ventricular mass | 130+/−40 | 83+/−21 | 0.0017 |
| LAVi Indexed left atrial volume | 51+/−17 | 24+/−6 | 0.0130 |
| EDVi Indexed end-diastolic volume | 117+/−43 | 43+/−11 | 0.0001 |
| ESV End-systolic volume | 183+/−74 | 36+/−18 | 0.0001 |
| ESVi Indexed end-systolic volume | 93+/−38 | 18+/−8 | 0.0001 |
| Mitral E/A | 1.89+/−1 | 1.26+/−0.1 | 0.2411 |
| EDT E wave deceleration time | 146+/−69 | 184+/−36 | 0.32 |
| E/septalE’ | 22+/−13 | 10+/−3.5 | 0.0697 |
Comparison of hemodynamic parameters between stage D HF patients and asymptomatic stage B patients
| Variable (mean value +/−SD) | advanced HF patients (n=18) | ‘pre-HF’ patients (n=12) | p value |
|---|---|---|---|
| PP Pulse pressure | 42+/−16 | 58+/−11 | 0.0054 |
| LVEF left ventricular ejection fraction | 25+/−7.7 | 57+/−7 | 0.0001 |
| TVI-LVOT Time velocity integral in the LVOT | 12.2+/−3.9 | 18.1+/−4 | 0.0004 |
| max lvot velocity | 72.5+/−13.6 | 95.8+/−19.2 | 0.0006 |
| SV stroke volume | 58.5+/−14 | 68.3+/−11.4 | 0.0534 |
| CI cardiac index | 1.96+/−0.34 | 2.35+/−0.52 | 0.0189 |
| PEP preejection time | 102+/−23 | 65+/−27 | 0.0004 |
| LVET LV ejection time | 261+/−43 | 322+/−27 | 0.0002 |
| PEP/LVET | 0.406+/−0.122 | 0.200+/−0.078 | 0.0001 |
| Ea effective arterial elastance (median) | 1.865+/−0.607 | 1.749+/−0.476 | 0.5806 |
| Ees ventricular elastance | 1.127+/−0.303 | 2.299+/−1.092 | 0.0002 |
| VAC ventriculo-arterial coupling | 1.745+/−0.353 | 0.895+/−0.340 | 0.0007 |
| CPO cardiac power output | 0.762+/−0.207 | 0.932+/−0.230 | 0.0440 |
| LVF left ventricular ejection force | 7.9+/−3.3 | 12.3+/−4.1 | 0.0041 |