TY - JOUR
T1 - Left ventricular pressure effects on right ventricular pressure and volume outflow
AU - Damiano, Ralph J.
AU - Cox, James Lewis
AU - Lowe, James E.
AU - Santamore, William P.
PY - 1990/4
Y1 - 1990/4
N2 - Massive destruction of the right ventricular free wall has been shown to cause only mild hemodynamic alterations. Further, the derivative of right ventricular (RV) pressure (P) is broad or double peaked, with one peak occurring coincidentally with peak left ventricular (LV) dP/dt. Both observations suggest a direct LV assistance to RV function. Since the ventricles contract nearly simultaneously, the relative contribution of LV to RV pump function has been difficult to determine. This LV assistance was quantified in six canine experiments using a unique electrically isolated RV preparation. While on total cardiopulmonary bypass, the RV free wall was electrically isolated from the remainder of the heart. This preparation allowed for wide variations in the timing interval between RV and LV contractions. Double‐peaked waveforms for RVP and pulmonary flow (RVF) occurred over a wide range (0 to 300 ms) of pacing intervals between the RV and LV. One derivative peak always followed RV contraction for RVP and RVF (r = 0.971 ± .011, P 0.01: r = 0.972 ± .012, p < 0.01; respectively). The second derivative peak was unrelated to the RA‐RV pacing interval (r = 0.297 ± .191, P > 0.5 RVP; 4 = 0.237 ± .278, P > 0.5 RVF), but corresponded to the maximal LVP rise. Additionally, the magnitude of the two derivative peaks was similar when the ventricles contracted synchronously. When RV contraction preceded or followed LV contraction, the derivative peak associated with LV contraction was significantly greater (P < 0.05, range 2.1 ± 0.6 to 6.7 ± 1.6 for RVP; P ± 0.05 range 1.9 ± 0.4 to 6.7 ± 1.5 for RVF) than the derivative associated with RV contraction. These data demonstrate a normally present, large LV assistance to RV contraction and may help to explain the RV response to myocardial infarction.
AB - Massive destruction of the right ventricular free wall has been shown to cause only mild hemodynamic alterations. Further, the derivative of right ventricular (RV) pressure (P) is broad or double peaked, with one peak occurring coincidentally with peak left ventricular (LV) dP/dt. Both observations suggest a direct LV assistance to RV function. Since the ventricles contract nearly simultaneously, the relative contribution of LV to RV pump function has been difficult to determine. This LV assistance was quantified in six canine experiments using a unique electrically isolated RV preparation. While on total cardiopulmonary bypass, the RV free wall was electrically isolated from the remainder of the heart. This preparation allowed for wide variations in the timing interval between RV and LV contractions. Double‐peaked waveforms for RVP and pulmonary flow (RVF) occurred over a wide range (0 to 300 ms) of pacing intervals between the RV and LV. One derivative peak always followed RV contraction for RVP and RVF (r = 0.971 ± .011, P 0.01: r = 0.972 ± .012, p < 0.01; respectively). The second derivative peak was unrelated to the RA‐RV pacing interval (r = 0.297 ± .191, P > 0.5 RVP; 4 = 0.237 ± .278, P > 0.5 RVF), but corresponded to the maximal LVP rise. Additionally, the magnitude of the two derivative peaks was similar when the ventricles contracted synchronously. When RV contraction preceded or followed LV contraction, the derivative peak associated with LV contraction was significantly greater (P < 0.05, range 2.1 ± 0.6 to 6.7 ± 1.6 for RVP; P ± 0.05 range 1.9 ± 0.4 to 6.7 ± 1.5 for RVF) than the derivative associated with RV contraction. These data demonstrate a normally present, large LV assistance to RV contraction and may help to explain the RV response to myocardial infarction.
KW - cardiac mechanics
KW - left ventricle
KW - right ventricle
KW - ventricular interdependence
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U2 - 10.1002/ccd.1810190411
DO - 10.1002/ccd.1810190411
M3 - Article
C2 - 2334962
AN - SCOPUS:0025284243
SN - 0098-6569
VL - 19
SP - 269
EP - 278
JO - Catheterization and cardiovascular diagnosis
JF - Catheterization and cardiovascular diagnosis
IS - 4
ER -