Importance of left ventricular function and systolic ventricular interaction to right ventricular performance during acute right heart ischemia

J. A. Goldstein, J. S. Tweddell, B. Barzilai, Y. Yagi, Allan S Jaffe, J. L. Cox

Research output: Contribution to journalArticle

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Abstract

To determine whether modulation of systolic ventricular interaction influences right ventricular performance during right heart ischemia, the effects of septal ischemia and inotropic stimulation were studied in 15 dogs in an open chest preparation. Right coronary branch occlusions led to right ventricular dilation and free wall dyskinesia, reversed septal curvature and reduced left ventricular diastolic volume. In systole, the septum thickened but bulged paradoxically into the right ventricle generating an active but depressed right ventricular systolic pressure (28.9 ± 5.5 to 22.1 ± 4.5 mm Hg), with associated decreases in right ventricular stroke work (5.66 ± 0.94 to 1.92 ± 0.53 g·m/m 2) and left ventricular systolic pressure (123 ± 11 to 80 ± 10 mm Hg). Septal ischemia induced systolic septal thinning, left ventricular dilation and decreased left ventricular systolic pressure (80 ± 10 to 55 ± 10 mm Hg) and stroke work. Although the extent of paradoxic septal displacement increased, there were further decrements in right ventricular systolic pressure (22.1 ± 4.5 to 18.7 ± 4.3 mm Hg) and stroke work (1.92 ± 0.53 to 0.7 ± 0.2 g·m/m 2). Dopamine infusion augmented left ventricular systolic pressure (55 ± 10 to 172 ± 17 mm Hg) and stroke work. Although systolic septal thinning persisted, the extent of paradoxic septal displacement increased strikingly and, despite continued right ventricular free wall dyskinesia, right ventricular systolic pressure increased (18.7 ± 4.3 to 39.6 ± 6.2 mm Hg) as did right ventricular stroke work (0.7 ± 0.2 to 7 ± 1.6 g·m/m 2). Therefore, the magnitude of systolic interaction is an important determinant of right ventricular performance during right heart ischemia. Septal dysfunction diminishes this interaction, whereas inotropic stimulation augments this compensatory mechanism.

Original languageEnglish (US)
Pages (from-to)704-711
Number of pages8
JournalJournal of the American College of Cardiology
Volume19
Issue number3
StatePublished - 1992
Externally publishedYes

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Ventricular Pressure
Left Ventricular Function
Ischemia
Blood Pressure
Stroke
Dyskinesias
Dilatation
Systole
Coronary Occlusion
Heart Ventricles
Dopamine
Thorax
Dogs
Gm(m)

ASJC Scopus subject areas

  • Nursing(all)

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Importance of left ventricular function and systolic ventricular interaction to right ventricular performance during acute right heart ischemia. / Goldstein, J. A.; Tweddell, J. S.; Barzilai, B.; Yagi, Y.; Jaffe, Allan S; Cox, J. L.

In: Journal of the American College of Cardiology, Vol. 19, No. 3, 1992, p. 704-711.

Research output: Contribution to journalArticle

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