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Correlation among right ventricular preload, afterload and ejection fraction in mitral valve disease: Radionuclide, echocardiographic and hemodynamic evaluation
Journal article   Peer reviewed

Correlation among right ventricular preload, afterload and ejection fraction in mitral valve disease: Radionuclide, echocardiographic and hemodynamic evaluation

Abdulmassih S. Iskandrian, A-hamid Hakki, Jian-Fang Ren, Morris N. Kotler, Gary S. Mintz, John Ross, Sally A. Kane and Julia C Ross
Journal of the American College of Cardiology, v 3(6), pp 1403-1411
Jun 1984
DOI: https://doi.org/10.1016/S0735-1097(84)80278-8
PMID: 6715700
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

The relation among right ventricular preload, afterload and ejection fraction in patients with mitral valve disease has not been well elucidated. In this study, measurements were made of intracardiac pressures and forward cardiac output during cardiac catheterization (n = 43), the ejection fraction by radionuclide angiography (n = 43) and end-systolic radius and wall thickness by Mmode echocardiography (n = 22). There was a linear correlation between pulmonary artery pressure and right atria] pressure (r = 0.57, p < 0.01). The right ventricular peak circumferential systolic wall stress was increased in 68% of the patients (in comparison with wall stress measurements obtained in 10 normal subjects). The right ventricular ejection fraction was abnormal in 38 patients (88%) and abnormal in 14 of the 15 patients with high wall stress. There was an inverse correlation between ejection fraction and end-diastolic volume (r = -0.61, p p < 0.001). The right ventricular ejection fraction measurement was repeated within 3 months after mitral valve replacement in 16 patients; the ejection fraction increased from 21 ± 9 to 29 ± 10% (mean ± standard deviation) after surgery (p < 0.01), but normalization of the ejection fraction was observed in only 3 patients (19%). Thus, abnormal right ventricular ejection fraction, which is observed in most patients with rheumatic mitral valve disease, results from inappropriate wall stress or depressed inotropic response of the right ventricle due to damage. Right ventricular dilation appears to be a compensatory mechanism to maintain the cardiac output.

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35 citations in Web of Science
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Web of Science research areas
Cardiac & Cardiovascular Systems
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