Measuring stress velocity index using mean blood pressure: Simple yet accurate?

Sanjeev Aggarwal, Michael D. Pettersen, Joellyn Gurckzynski, Thomas L'Ecuyer

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

The stress velocity index, or the relationship of the rate-corrected mean velocity of circumferential shortening (VCFc) to the end systolic wall stress (ESWS), is a sensitive, load-independent measure of left ventricular contractility. ESWS is technically difficult to obtain and requires simultaneous blood pressure measurement, carotid artery tracing, and phonocardiogram. We report our comparison of two simpler methods of measuring ESWS and, therefore, stress velocity index. Patients with normal cardiac anatomy who had completed anthracycline chemotherapy were evaluated. ESWS as measured by the standard method using a carotid artery tracing (ESWScar) was compared to ESWS obtained using mean arterial pressure (ESWSmap) or systolic blood pressure (ESWSsbp). The cohort included 63 patients, with 37 (59%) males and a median age of 13.1 years. The mean (±SD) ESWScar was 53.3±15.3 g/cm2 (range, 26.3-94 g/cm2); ESWSmap, 53 ±13.4 g/cm2 (range, 27.1-86.1 g/cm2); and ESWSsbp, 72.9 ± 18.2 g/cm 2 (range, 40.8-117.2 g/cm2). ESWSmap and ESWSsbp closely correlated with ESWScar (coefficient correlation r = 0.88 and r = 0.87, respectively). Using ESWSmap, all patients were correctly classified as having normal or abnormal contractility as defined by stress velocity index, whereas ESWSsbp detected only two of the six patients with impaired contractility. We conclude that ESWSmap is a simple, highly sensitive and specific method for assessing left ventricular contractility. ESWSmap correlates closely with ESWScar and can be incorporated into the monitoring of cardiac dysfunction in the anthracycline-treated population. Further studies are needed to determine if this simplified measure accurately assesses the ESWS in other cardiac disease states.

Original languageEnglish
Pages (from-to)108-112
Number of pages5
JournalPediatric Cardiology
Volume29
Issue number1
DOIs
StatePublished - Jan 2008

Keywords

  • Echocardiogram
  • Left ventricle
  • Load independent
  • Systolic function

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