Author + information
- Received April 17, 1991
- Revision received June 18, 1991
- Accepted July 12, 1991
- Published online January 1, 1992.
- Eric K. Louie, MD, FACC1,∗,
- Stuart Rich, MD, FACC1,∗,
- Sidney Levitsky, MD, FACC1,† and
- Bruce H. Brundage, MD, FACC1,‡
- ↵∗Address for reprints: Eric K. Louie, MD, Section of Cardiology, Loyola University Medical Center, 2160 South First Avenue, Maywood, Illinois 60153.
To compare the effects of isolated right ventricular pressure and volume overload on left ventricular diastolic geometry and filling, 11 patients with primary pulmonary hypertension, 11 patients with severe tricuspid regurgitation due to tricuspid valve resection and 11 normal subjects were studied with use of Doppler echocardiography techniques. Right ventricular systolic overload in primary pulmonary hypertension resulted in substantial leftword ventricular septal shift that was most marked at end-systole and early diastole and decreased substantially by end-diastole. Right ventricular diastolic overload after tricuspid valve resection resulted in maximal leftward ventricular septal shift at end-diastole sparing end-systole and early diastole. The early diastolic distortion of left ventricular geometry associated with right ventricular pressure overload resulted in prolongation of isovolumetric relaxation of the left ventricle (129 ± 39 ms) and a reduction in early diastolic finding compared with values in normal subjects.
Late diastolic distortion of left ventricular geometry associated with right ventricular volume overload had no influence on the duration of left ventricular isovolumetric relaxatoon (52 ± 32 ms) but caused a reduction in the atrial systolic contribution to late distolic filling of the left ventricle compared with values in normal sujects. In patients with right ventricular pressure overload, 52 ± 16% of left ventricular filling occurred in early diastole compared with 78 ± 11% in patients with right ventricular volume overload (p < 0.001). The differential effects of systolic and diastolic right ventricular overload on the pattern of left ventricular filling appear to bt related to the timing of leftward ventricular septal displacement.
☆ This report was presented in part at the 38th Scientific Session of the American College of Cardiology, Anaheim, California, March 22, 1989.
- Received April 17, 1991.
- Revision received June 18, 1991.
- Accepted July 12, 1991.