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Significant differences between participants watching the anger- versus the fear-eliciting sequences were found in heart rate, stroke volume, myocardial contractility, cardiac output, and total peripheral resistance, whereas no differences were observed in blood pressure, LVET, and PEP.
The IMP is calculated as the Doppler derived sum of the isovolumic contraction time (ICT) and isovolumic relaxation time (IRT) divided by the left ventricular ejection time (LVET) (3).
Clinically, LV volume overload produced by chronic aortic regurgitation (AR) results in a prolonged LVET (7-11) and may theoretically reduce IMP.
Transaortic Doppler was used to obtain LVET, which was measured from the onset to the end of the aortic velocity spectrum.
The ICT was determined by subtracting LVET and IRT from "a".
Both AR groups demonstrated prolonged LVET's as compared to normals.
We hypothesized that AR as a volume overload lesion would prolong LVET (8-10) and possibly reduce IMP.
We demonstrated that AR+Normal EF patients had a prolonged LVET and IRT resulting in an IMP that did not differ from the normal group.
They demonstrated increases in ICT and IRT and shortening of the LVET. These findings are more consistent with pressure loading with LV dysfunction or cardiomyopathy (1,6) or end stage AR where preload reserve has been exhausted and afterload excess is evident (18, 19).
Previous data in the literature has noted that the LVET is prolonged in AR, which may have the effect of reducing IMP (8-10).
The LVET increased with volume loading (5,20) in both human and experimental studies.
The IMP is most useful as a predictive index when ICT and IRT increase and LVET decrease as in patients post myocardial infarction and with dilated cardiomyopathy (1,2).
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