Determinant Factors of Right Ventricular Function and Ventricular Interaction by Angiographic Method, with Special Reference to the Evaluation of Right Ventricular Ejection Fraction

  • Kawano Tatsuhiko
    Department of Internal Medicine, Kitasato University School of Medicine
  • Noro Chuji
    Department of Internal Medicine, Kitasato University School of Medicine
  • Kikawada Ryuichi
    Department of Internal Medicine, Kitasato University School of Medicine

Bibliographic Information

Other Title
  • 右室造影による右心機能とくに右室駆出分画の評価および左右心室の相互関係

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Description

Right ventricular (RV) function and determinant factors of the RV function were elucidated and the interaction between the right and left ventricles was investigated in 33 patients with three kinds of cardiac disease. The study included 16 patients having myocardial infarction with a backward failure of the left ventricle (LV) caused by myocardial damage, 10 patients with mitral stenosis having a backward failure of LV caused by obstruction of LV inflow, and 7 patients with atrial septal defect characterized by a volume overload on the RV and, in severe cases, pressure overload on RV. The findings were compared with those in 6 cases of a normal heart condition. The volume and the pressure of the right and left heart were measured invasively, and a considerable inverse correlation was noted between the RV ejection fraction (RVEF) and the pressure load on RV. This indicates that pressure load is a strong determinant factor of RV function. In contrast to findings on the pressure load, however, no correlation was evident between RVEF and RV end-diastolic volume index (RVEDVI), showing that volume load played no key role in determining the RV function. Normal RVEF demonstrated the capacity to maintain central venous pressure (CVP) within the normal range, and the normal LV ejection fraction (LVEF) showed the capacity to maintain normal cardiac pump performance (CI). Results of the study identify cardiac pump performance as the function of the LV, and the normalization of CVP as that of the RV. In cases of a burdened RV due to the pressure load caused by LV backward failure, RVEF was superintended by LVEF, demonstrating that a strong influence from LV function was superinduced on the RV function. Further ventricular interaction was observed in the presence of an increase in the resistance ratio (RVR/SVR).

Journal

  • Kitasato medicine

    Kitasato medicine 19 (6), 565-574, 1989-12-31

    Kitasato University

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