Characterisation of the normal right ventricular pressure-volume relation by biplane angiography and simultaneous micromanometer pressure measurements.

Abstract

SUMMARYThe normal right ventricular pressure-volume relation was studied by recording biplane right ventriculograms with simultaneous high fidelity pressure recordings in 10 adults found to have normal coronary arteries and haemodynamic function at diagnostic cardiac catheterisation. Right ventricular volume was measured frame by frame from digitised ventriculograms by a modification of Simpson's rule. The accuracy of this method was tested in a study of 22 human and animal right ventricular casts. There was excellent agreement between calculated volumes and those measured by fluid displacement. The derived regression equations were used to correct right ventricular volumes calculated from in vivo studies. The mean (SD) end diastolic volume index for the group was 62 (13) ml/m2, the stroke volume index was 43 (8) ml/M2, and the ejection fraction was 62 (6)%. Right ventricular pressure-volume loops were generated by combining simultaneous volume and pressure curves. The normal right ventricular pressure-volume loop was triangular, departing significantly from the square or rectangle of the normal left ventricular pressure-volume loop. Ejection from the right ventricle began early during the pressure rise and continued as right ventricular pressure fell. As a result phases of isovolumic contraction and relaxation were difficult to define.These observations show that normal right ventricular pressure-volume relations differ considerably from those of the normal left ventricle, presumably reflecting the different loading conditions of the two ventricles.Unlike the left ventricle, the right ventricle has been largely ignored in terms of the detailed characterisation of its function. Probably the most important factor responsible for this has been the difficulty in accurately measuring right ventricular volume as a result of its complex geometric shape. Unlike the normal left ventricle, which approximates to a prolate ellipsoid, the right ventricle does not lend itself to volume calculation on the basis of a simple geometric assumption. None the less, various methodsRequests for reprints to Dr

Transcriptomic profiling of the canine tachycardia-induced heart failure model: global comparison to human and murine heart failure

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Right Versus Left Ventricular Failure

“…This compensated RV adaptation to chronic afterload occurs through increased contractility, manifested by a steeper end-systolic pressure-volume relation (Figure 3), 18,19 thereby preserving cardiac output. 19 However, with disease progression, the RV ultimately fails, leading to further RV dilatation, a rightward shift in the pressure-volume curve, and a resultant decrease in end-systolic elastance and compromised cardiac output ( Figure 3 …”

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