Details

Autor(en) / Beteiligte

• Jani, Vivek
• Konecny, Filip
• Shelby, Aaron
• Kulkarni, Aparna
• Hammel, James
• Schuster, Andreas
• Lof, John
• Zhan, Junzhen
• Barnes, Benjamin
• Fernandes, Joao Filipe
• Danford, David
• Kutty, Shelby

Titel

Influence of right ventricular pressure and volume overload on right and left ventricular diastolic function

Ist Teil von

• The Journal of thoracic and cardiovascular surgery, 2022-04, Vol.163 (4), p.e299-e308

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2022

Link zum Volltext

Quelle

ScienceDirect

Beschreibungen/Notizen

• Ventricular interdependence may account for altered ventricular mechanics in congenital heart disease. The present study aimed to identify differences in load-dependent right ventricular (RV)–left ventricular (LV) interactions in porcine models of pulmonary stenosis (PS) and pulmonary insufficiency (PI) by invasive admittance-derived hemodynamics in conjunction with noninvasive cardiovascular magnetic resonance (CMR). Seventeen pigs were used in the study (7 with PS, 7 with PI, and 3 controls). Progressive PS was created by tightening a Teflon tape around the pulmonary artery, and PI was created by excising 2 leaflets of the pulmonary valve. Admittance catheterization data were obtained for the RV and LV at 10 to 12 weeks after model creation, with the animal ventilated under temporary diaphragm paralysis. CMR was performed in all animals immediately prior to pressure–volume catheterization. In the PS group, RV contractility was increased, manifested by increased end-systolic elastance (mean difference, 1.29 mm Hg/mL; 95% confidence interval [CI], 0.57-2.00 mm Hg/mL). However, in the PI group, no significant changes were observed in RV systolic function despite significant changes in RV diastolic function. In the PS group, LV end-systolic volume was significantly lower compared with controls (mean difference, 25.1 mL; 95% CI, -40.5 to -90.7 mL), whereas in the PI group, the LV showed diastolic dysfunction, demonstrated by an elevated isovolumic relaxation constant and ventricular stiffness (mean difference, 0.03 mL−1; 95% CI, -0.02 to 0.09 mL−1). The LV exhibits systolic dysfunction and noncompliance with PI. PS is associated with preserved LV systolic function and evidence of some LV diastolic dysfunction. Interventricular interactions influence LV filling and likely account for differential effects of RV pressure and volume overload on LV function. Porcine models of pressure and volume overload. We developed and acquired pressure–volume loops from porcine models of pulmonary stenosis (PS) and pulmonary insufficiency (PI) from both the right and left ventricles. In addition to expected changes in contractility in compliance for each respective model, we observed mild diastolic dysfunction in both models, suggesting that interventricular interactions are important in understanding pathophysiology. [Display omitted]