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Radial pressure waveform dP/dt max is a poor indicator of left ventricular systolic function

journal contribution
posted on 2023-05-17, 01:37 authored by James SharmanJames Sharman, Qasem, AM, Hanekom, L, Gill, DS, Lim, R, Marwick, TH
Background: The first derivative of left ventricular (LV) pressure over time (dP/dt max) is a marker of LV systolic function that can be assessed during cardiac catheterization and echocardiography. Radial artery dP/dt max has been proposed as a possible marker of LV systolic function and we sought to test this hypothesis. Materials and methods: We compared simultaneously recorded radial dP/dt max (by high-fidelity tonometry) with LV dP/dt max (by high-fidelity catheter and echocardiography parameters analogous to LV dP/dt max). In study 1, beat-to-beat radial dP/dt max and LV dP/dt max were recorded at rest and during supine exercise in 12 males (aged 61 ± 12 years) undergoing cardiac catheterization. In study 2, 2D-echocardiography and radial dP/dt max were recorded in 54 patients (separate to study 1; 39 men; aged 64 ± 10 years) at baseline and peak dobutamine-induced stress. Three basal septum measures were taken as being analogous to LV dP/dt max: 1. Peak systolic strain rate; 2. Strain rate (SR-dP/dt max) during isovolumic contraction (IVCT) and; 3. Tissue velocity during IVCT. Results: In study 1 there was a significant difference between resting LV dP/dt max (1461 ± 383 mmHg s-1) and radial dP/dt max (1182 ± 319 mmHg s-1; P < 0.001), and a poor, but statistically significant, correlation between the variables (R2 = 0.006; P < 0.05). Similar results were observed during exercise. In study 2 there were weak (R2 = -0.12; P = 0.01) to non-significant associations between radial dP/dt max and all echocardiographic measures analogous to LV dP/dt max at rest or peak stress. Conclusion: Radial pressure waveform dP/dt max is not a reliable marker of LV systolic function.


Publication title

European Journal of Clinical Investigation










Menzies Institute for Medical Research


Blackwell Publishing Ltd

Place of publication

9600 Garsington Rd, Oxford, England, Oxon, Ox4 2Dg

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  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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