Author + information
- Received March 27, 1984
- Revision received January 7, 1985
- Accepted January 21, 1985
- Published online June 1, 1985.
- Marvin A. Konstam, MD, FACC*,1,
- Steven R. Cohen, MD1,
- Deeb N. Salem, MD, FACC1,
- Thomas P. Conlon, MS1,
- Jeffrey M. Isner, MD, FACC1,
- Dhirendra Das, MD1,
- Michael R. Zile, MD1,
- Herbert J. Levine, MD, FACC1 and
- Paul C. Kahn, MD1
- ↵*Address for reprints: Marvin A. Konstam, MD, Box 108, New England Medical Center, 171 Harrison Avenue, Boston, Massachusetts 02111.
A hemodynamic-radionuclide study was performed to compare the relations between end-systolic pressure and volume in the left and right ventricles in 10 patients with biventricular failure, and to correlate the end-systolic pressure-volume slope with baseline variables of systolic function. During nitroprusside or nitroglycerin infusion, or a combination of both, linear relations were found between end-systolic pressure and volume for both ventricles. In 9 of 10 patients, the end-systolic pressure-volume slope was greater for the left ventricle (mean ± SD 1.12 ± 0.36 mm Hg·m2/ml) than for the right ventricle (0.46 ± 0.27 mm Hg·m2/ml) (p < 0.001). In all 10 patients, the volume-axis intercept of the pressure-volume relation was greater for the left ventricle (82 ± 66 ml/m2) than for the right ventricle (2 ± 30 ml/m2) (p < 0.005). Right ventricular pressure-volume slope corre- lated weakly with baseline right ventricular ejection fraction (r = 0.69, p < 0.05), strongly with the baseline right ventricular end-systolic pressure-volume ratio (r = 0.89) and inversely with baseline right ventricular end-systolic volume (r = −0.86).
In conclusion, 1) in patients with severe biventricular failure, changes in systolic pressure influence end-systolic volume more strongly in the right than in the left ventricle. 2) For the right ventricle, the slope of the end-systolic pressure-volume relation is directly related to rest indexes of systolic function. 3) The greater the end-systolic volume at rest, the greater the predicted improvement in right ventricular emptying for any vasodilator-induced reduction in pulmonary artery end-systolic pressure.
- Received March 27, 1984.
- Revision received January 7, 1985.
- Accepted January 21, 1985.
- American College of Cardiology Foundation