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artículo de revisión en forma precoz y no invasiva el estado contráctil intrínseco del miocardio y desenmascararlo del efecto de la carga ventricular, lo que a su vez permitirá indicar soluciones terapéuticas más tempranas y eficaces. En todo caso, hoy es más factible resistir la ironía del alumno: “La pregunta no es justa porque ustedes tampoco saben la respuesta”, cuando se le preguntó “¿qué es contractilidad?” Referencias 1. Katz AM. Physiology of the Heart. Four edition Lippincott 778 Williams & Wilkins, Philadelphia 2006. 2. Feneley M. Contractility: still searching after all these years. JACC Cardiovasc Imaging 2013; 6: 429-31. 3. Weidemann F, Jamal F, Sutherland GR, Claus P, Kowalski M, Hatle L, et al. Myocardial function defined by strain rate and strain during alterations in inotropic states and heart rate. Am J Physiol Heart Circ Physiol 2002; 283: H792-H9. 4. Ferferieva V, Van den Bergh A, Claus P, Jasaityte R, Veulemans P, Pellens M, et al. The relative value of strain and strain rate for defining intrinsic myocardial function. Am J Physiol Heart Circ Physiol 2012; 302: H188-H95. 5. Herrmann S, Bijnens B, Störk S, Niemann M, Hu K, Liu D, et al. Using simple imaging markers to predict prognosis in patients with aortic valve stenosis and unacceptable highrisk for operation. Am J Cardiol 2013; 112: 1819-27. 6. Shah AM, Claggett B, Sweitzer NK, Shah SJ Anand IS, Liu L, et al. Prognostic importance of impaired systolic function in heart failure with preserved ejection fraction and the impact of spironolactone. Circulation 2015; 132: 402-14. 7. Mentz RJ, Khouri MG. Longitudinal strain in heart failure with preserved ejection fraction: Is there a role for prognostication? Circulation 2015; 132: 368-70. 8. Suga H. Time course of left ventricular pressure-volume relationship under various extents of aortic occlusion. Jpn Heart J 1970; 11: 373-8. 9. Suga H. Time course of left ventricular pressure-volume relationship under various end diastolic volume. Jpn Heart J 1969; 10: 509-15. 10. Suga H, Sagawa K. Instantaneous Pressure-Volume relations hips and their ratio in the excised, supported canine left Ventricle. Circ Res 1974; 35: 117-26. 11. Burkhoff D, Mirsky I, Suga H. Assessment of systolic and diastolic ventricular properties via pressure-volume Contractilidad ventricular - R. J. Domenech et al analysis: a guide for clinical, translational, and basic researchers. Am J Physiol Heart Circ Physiol 2005; 289: H501-H12. 12. Sagawa K, Maughan WL, Suga H, Sunagawa K. Cardiac Contraction and the Pressure-Volume Relationship. Oxford Univ. Press 1988. 13. Kass DA, Maughan WL. From ‘Emax’ to pressure-volume relations: a broader view. Circulation 1988; 77: 1203-12. 14. Chen CH, Fetics B, Nevo F, Rochitte CE, Chiou KR, Ding PA, et al. Non invasive single-beat determination of left ventricular end-systolic elastance in humans. J Am Coll Cardiol 2001; 38: 2028-34. 15. Klotz S, Hay I, Dickstein ML, Wang J, Maurer MS, Kass DA, et al. 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-H12. 16. Burkhoff D. Pressure-volume loops in clinical research: a contemporary view. J Am Coll Cardiol 2013; 62: 1173- 6. 17. Ky B, French B, May Khan AM, Plappert T, Wang A, Chirinos JA, et al. Ventricular-arterial coupling, remodeling, and prognosis in chronic heart failure. J Am Coll Cardiol 2013; 62: 1165-72. 18. He KL, Burkhoff D, Leng WX, Liang ZR, Fan L, Wang J, et al. Comparison of ventricular structure and function in Chinese patients with heart failure and ejection fractions > 55% versus 40% to 55% versus < 40%. Am J Cardiol 2009; 103: 845-51. 19. Borlaug BA, Paulus WJ. Heart Failure with preserved ejection fraction: pathophysiology, diagnosis, and treatment. Eur Heart J 2011; 32: 670-9. 20. Lam CSP, Roger VL, Rodeheffer RJ, Bursi F, Borlaug BA, Ommen SR, et al. Cardiac structure and ventricular vascular function in persons with heart failure and preserved ejection fraction from Olmsted County, Minnesota. Circulation 2007; 115: 1982-90. 21. Bhuiyan T, Helmke S, Patel AR, Ruberg FL, Packman J, Cheung K, et al. Pressure-volume relationships in patient with transthyretin (ATTR) cardiac amyloidosis secondary to V122I mutations and wild-type transthyretin. Transthyretin cardiac amyloid study (TRACS). Circ Heart Fail 2011; 4: 121-8. 22. Maurer MS, Sackner-Bernstein JD, El-Khoury Rumbarger L, Yushak M, King DL, Burkhoff D. Mechanisms underlying improvements in ejection fraction with carvedilol in heart failure. Circ Heart Fail 2009; 2: 189-96. 23. Gaemperli O, Biaggi P, Gugelmann R, Osranek M, Schreuder JJ, Bühler I, et al. Real-time left ventricular Rev Med Chile 2016; 144: 771-779


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