The use of the ratio of PEP to left ventricular ejection time (LVET) as a measure of performance was developed at Wayne State University Medical School some years ago. The normal value of 0.35 is elevated in cases of pathology. As shown graphically in Figure 2.09, the end of LVET is indicated by the second heart sound. The fact that PEP/LVET can be obtained non-invasively from the ECG, heart sounds, and carotid pulse is a major advantage.
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