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The effects of pressure‐induced right ventricular hypertrophy on left ventricular diastolic properties and dynamic geometry in the conscious dog

 

作者: MARC,   VISNER CARL,   ARENTZEN ARTHUR,   CRUMBLEY E.,   LARSON MELODY,   O'CONNOR ROBERT,  

 

期刊: Circulation  (OVID Available online 1986)
卷期: Volume 74, issue 2  

页码: 410-419

 

ISSN:0009-7322

 

年代: 1986

 

出版商: OVID

 

数据来源: OVID

 

摘要:

To determine whether chronic pressure overload and hypertrophy of the right ventricle alter the diastolic properties of the left ventricle, six adult dogs underwent banding of the pulmonary artery and were instrumented for studies 8 months later. Fourteen control dogs were also studied. Pressure and dimension data were collected from the dogs while they were awake and unsedated. The anterior-posterior, septal-free wall, and base-apex axis diameters of the left ventricle were measured with ultrasonic dimension transducers. Right and left ventricular pressures were measured with micromanometers. Pulmonary arterial banding resulted in increased right ventricular/body mass ratios (2.70 + 0.36 g/kg vs 1.52 + 0.15 g/kg control; p ' .05) and increased left ventricular/body mass ratios (4.84 ± 0.64 g/kg vs 4.21 ± 0.49 g/kg control; p ' .05). Right ventricular peak systolic and enddiastolic pressures were higher among the banded dogs (50 ± 20/7 + 5 mm Hg vs 31 + 6/3 ± 2 mm Hg control; p ' .05). A rearrangement in the three-dimensional geometry of diastolic filling occurred in the banded dogs. Extension from unstressed diastolic dimension (strain) in the base-apex axis was significantly larger in the banded dogs at left ventricular transmural pressures of 12, 8, and 4 mm Hg; strains in the septal-free wall axis were significantly smaller at transmural pressures of 12 and 8 mm Hg. Normalized diastolic left ventricular pressure-volume data and midwall circumferential stressstrain data were fit to the Kelvin viscoelastic equation. The normalized pressure-volume relationships of the banded dogs lay significantly to the left of those of the controls, indicating a loss of left ventricular chamber compliance. The midwall circumferential stress-strain relationships of the banded dogs were also shifted to the left, indicating a loss of intrinsic myocardial compliance. Thus, during the course of right ventricular hypertrophy caused by right ventricular pressure overload, alterations in the mass, geometry, and material properties of the left ventricle occur. At 8 months the chamber compliance of the left ventricle is compromised by these changes.

 

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