ArticleFrontiers in cardiovascular medicine2026
Validation of femoral pressure-derived assessment of effective arterial elastance in porcine ischemic cardiogenic shock.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: During ischemic cardiogenic shock (CS), increased afterload overburdens the damaged myocardium and may worsen outcomes. The measure, effective arterial elastance (Ea), integrates systemic vascular resistance, arterial compliance, and heart rate, and reflects left ventricular (LV) afterload. While Ea is traditionally derived from invasive LV pressure-volume (PV) analysis, a simplified bedside formula (0.9 × systolic arterial pressure/stroke volume) has been validated in stable intensive care patients. Its accuracy in CS, characterized by rapidly evolving hemodynamics, remains unknown. Methods: In total, 20 female Danish Landrace pigs were instrumented with a femoral arterial catheter, pulmonary artery catheter (PAC), and LV PV catheter. CS was induced by microsphere embolization of the left main coronary artery. Ea was estimated from femoral arterial pressure and stroke volume measured with the PAC and compared with PV-derived Ea as a reference. Ea was measured at healthy baseline, CS onset, 60 minutes of untreated CS and after a dobutamine infusion. Agreement was evaluated with Pearson correlation and Bland-Altman analysis. Results: At baseline, onset of CS, and at established CS, correlations between the estimated and the PV-derived Ea remained strong ( Conclusions: Estimated Ea reliably reproduced PV-derived Ea during disease states. This simple bedside measure may enable continuous monitoring of afterload in ischemic CS without LV catheterization.
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