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Letter To the Editor

Dear Editor: In the June issue of Angiology, Spaccavento et al’ examine the effects of ischemia on left ventricular contractility in patients with coronary artery disease using the elastance (Emax) parameter of the end-systolic pressurevolume relationship (ESPVR) as an index of contractility. Over the past ten years, a number of papers containing errors in the construction of the ESPVR have been published. These errors, in general terms, consist in confusion between end-systole and end-ejection, insufficient quantity of P-V data points to work out the linear regression analysis, and loading maneuvers of inadequately long duration. But the errors contained in the report by Spaccavento et al’ are of unusual gravity. The authors not only repeat the above-mentioned errors but also neglect the possibility that their experimental interventions could modify the volume intercept (VO) of the ESPVR. In effect, after constructing a control ESPVR us-