Hemodynamic maneuvers increased contractility-sensitive pressure-strain loop indices during exercise (Cohen's dz 0.88-1.29, p<0.001) and pressure indices during handgrip (Cohen's dz 0.77-1.21).
Observational
Do standardized hemodynamic maneuvers alter pressure-strain loop indices in healthy volunteers?
Pressure-strain loop analysis using speckle-tracking echocardiography can non-invasively detect physiologically meaningful hemodynamic responses consistent with ventriculo-arterial coupling physiology.
Effect estimate: Cohen's dz 0.88-1.29 (exercise) and 0.77-1.21 (handgrip/leg raising)
p-value: p=<0.001
Pressure-strain loop (PSL) analysis integrates myocardial deformation with estimated left ventricular pressure and may provide a non-invasive approach for assessing ventriculo-arterial coupling. However, its physiological behavior under controlled hemodynamic stress has not been systematically evaluated in humans. In this prospective physiologic study, healthy volunteers underwent standardized hemodynamic maneuvers. One cohort performed semi-supine exercise (contractility-dominant), while a second cohort underwent isometric handgrip followed by modified passive leg raising (afterload- and preload-modulating maneuvers). Left-ventricular PSL indices were derived from speckle-tracking echocardiography combined with brachial pressure calibration. Five pre-specified PSL indices reflecting afterload (PSL-derived arterial elastance (EaPSL), end-systolic pressure), contractility (systolic strain rate, peak systolic strain), and myocardial work (global work index) were defined as co-primary endpoints. Within-subject changes were analyzed using paired tests with Holm-Bonferroni correction. Exercise produced large increases in contractility-sensitive indices (Cohen's dz 0.88-1.29, all adjusted p < 0.001), while pressure indices rose selectively with handgrip and modified passive leg raising (Cohen's dz 0.77-1.21, adjusted p ≤ 0.001). These findings demonstrate that PSL analysis detects physiologically meaningful hemodynamic responses in humans and yields non-invasive indices whose directional behavior is consistent with established ventriculo-arterial coupling physiology.
Mendes et al. (Thu,) conducted a observational in Healthy volunteers. Standardized hemodynamic maneuvers (semi-supine exercise, isometric handgrip, modified passive leg raising) vs. Baseline (within-subject changes) was evaluated on Five pre-specified pressure-strain loop (PSL) indices reflecting afterload, contractility, and myocardial work (Cohen's dz 0.88-1.29 (exercise) and 0.77-1.21 (handgrip/leg raising), p=<0.001). Hemodynamic maneuvers increased contractility-sensitive pressure-strain loop indices during exercise (Cohen's dz 0.88-1.29, p<0.001) and pressure indices during handgrip (Cohen's dz 0.77-1.21).