{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:49:19Z","timestamp":1792511359955,"version":"4.5.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Noninvasive indices based on Doppler echocardiography are increasingly used in clinical cardiovascular research to evaluate left ventricular global systolic chamber function. Our objectives were to clinically validate ultrasound-based methods of global systolic chamber function to account for differences between patients in conditions of abnormal load, and to assess their sensitivity to load confounders.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Twenty-seven patients (8 dilated cardiomyopathy, 10 normal ejection fraction, and 9 end-stage liver disease) underwent simultaneous echocardiography and left heart catheterization with pressure-conductance instrumentation. The reference index, maximal elastance (\n              <jats:italic>E<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              ), was calculated from pressure\u2013volume loop data obtained during acute inferior vena cava occlusion. A wide range of values were observed for left ventricular systolic chamber function (\n              <jats:italic>E<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              : 2.8\u00b11.0 mm Hg\/mL), preload, and afterload. Among the noninvasive indices tested, the peak ejection intraventricular pressure difference showed the best correlation with\n              <jats:italic>E<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              (\n              <jats:italic>R<\/jats:italic>\n              =0.75). A significant but weaker correlation with\n              <jats:italic>E<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              was observed for ejection fraction (\n              <jats:italic>R<\/jats:italic>\n              =0.41), midwall fractional shortening (\n              <jats:italic>R<\/jats:italic>\n              =0.51), global circumferential strain (\n              <jats:italic>R<\/jats:italic>\n              =\u22120.53), and strain rate (\n              <jats:italic>R<\/jats:italic>\n              =\u22120.46). Longitudinal strain and strain rate failed to correlate with\n              <jats:italic>E<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              , as did noninvasive single-beat estimations of this index. Principal component and multiple regression analyses demonstrated that peak ejection intraventricular pressure difference was less sensitive to load, whereas ejection fraction and longitudinal strain and strain rate were heavily influenced by afterload.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Current ultrasound methods have limited accuracy to characterize global left ventricular systolic chamber function in a given patient. The Doppler-derived peak ejection intraventricular pressure difference should be preferred for this purpose because it best correlates with the reference index and is more robust in conditions of abnormal load.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.113.000722","type":"journal-article","created":{"date-parts":[[2013,10,31]],"date-time":"2013-10-31T03:46:25Z","timestamp":1383191185000},"page":"164-172","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":63,"title":["Validation of Noninvasive Indices of Global Systolic Function in Patients With Normal and Abnormal Loading Conditions"],"prefix":"10.1161","volume":"7","author":[{"given":"Raquel","family":"Yotti","sequence":"first","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Bermejo","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"Benito","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Sanz-Ruiz","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Ripoll","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Mart\u00ednez-Legazpi","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candelas P\u00e9rez","family":"del Villar","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"El\u00edzaga","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Gonz\u00e1lez-Mansilla","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Barrio","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Ba\u00f1ares","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Fern\u00e1ndez-Avil\u00e9s","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A.) and Gastroenterology and CIBERehd (C.R., R.B.), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain; Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain (R.Y., J.B., Y.B., R.S., C.P.d.V., J.E., A.G.-M., A.B., F.F.-A., C.R., R.B.); and Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla (P.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.111.969956"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.139535"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0036115"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hfc.2011.03.003"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.541078"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.659763"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.104.500488"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc0102.101396"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.485128"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01651-5"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.108.806240"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(77)90192-8"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.76.6.1422"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.308.6933.896"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840080532"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1810150314"},{"issue":"5","key":"e_1_3_4_18_2","first-page":"H773","article-title":"Left ventricular interaction with arterial load studied in isolated canine ventricle.","volume":"245","author":"Sunagawa K","year":"1983","unstructured":"Sunagawa K, Maughan WL, Burkhoff D, Sagawa K. 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