SIMULATOR 02 · LEFT VENTRICLE PATIENT RECONSTRUCTION & ENERGETICS KLOTZ EDPVR (2006)

Bedside Patient PV Loop & Mechanical Energetics

Reconstruct patient-specific left ventricular pressure-volume loops directly from non-invasive bedside measurements (cuff BP and echocardiographic volumes). Compare clinical phenotypes, assess ventriculo-arterial coupling, and quantify Suga stroke work and mechanical efficiency.

Preloaded Clinical Phenotypes
Coupling (Ea / Ees)
0.67
Physiologically Coupled
Stroke Volume (SV)
66.0 mL
ESV: 44.0 mL
Filling Press. (LVEDP)
11.8 mmHg
From E/e' ratio
End-Systolic Press.
108 mmHg
0.90 × SBP
Arterial Elastance (Ea)
1.64
mmHg / mL
Systolic Elastance (Ees)
2.45
mmHg / mL
Stroke Work (SW)
7,095
mmHg·mL (0.95 J)
Mechanical Efficiency
75%
SW / PVA Ratio

Left Ventricular Pressure-Volume Loop

Constructed non-invasively: Isovolumic phases, ejection dome, and Klotz EDPVR

Ventricular-Arterial Coupling

Ees (Contractility) vs Ea (Arterial Load)

Mechanical Energetics & Hemodynamics

Suga Pressure-Volume Area (PVA) & Cardiac Output

Physiological Parameter Formula / Origin Value
Cardiac Output (CO) (SV × HR) / 1000 4.75 L/min
Cardiac Power Output (CPO) (MAP × CO) / 451 0.95 W
Stroke Work (SW) ∮ P dV (Shoelace loop area) 7,095 mmHg·mL
Stroke Work (Joules) SW × 1.333 × 10−4 0.95 Joules
Potential Energy (PE) Area under ESPVR left of loop 2,376 mmHg·mL
Pressure-Volume Area (PVA) SW + PE (Total Mechanical Energy) 9,471 mmHg·mL
Mechanical Efficiency (η) SW / PVA × 100% 75%
Single-Beat Methodological Foundation
Diastolic stiffness curve fitted via the validated single-beat normalised EDPVR equation:
Klotz S, Hay I, Dickstein ML, Yi GH, Wang J, Maurer MS, Kass DA, Burkhoff D. Single-beat estimation of end-diastolic pressure–volume relationship: a novel method with potential for noninvasive application. Am J Physiol Heart Circ Physiol 2006;291:H403–H412. doi:10.1152/ajpheart.01240.2005 ↗

End-diastolic filling pressure estimated via Doppler echocardiography (Nagueh SF et al., JACC 1997: $\text{PCWP} \approx \text{LVEDP} = 1.24 \times (E/e') + 1.9$). Mechanical energetics evaluated using the Suga Pressure-Volume Area framework (Suga H, Physiol Rev 1990).