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November 1, 1993AJP Heart and Circulatory Physiology5 citations

Left ventricular unloading decreases rate of isovolumic right ventricular pressure decline

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CBCraig BrownECE. ChowDFDavid J. Farrar

Structured PICO

Does acute left ventricular unloading affect right ventricular relaxation in open-chest anesthetized pigs?

P
Population
Open-chest, anesthetized pigs
I
Intervention
Acute left ventricular (LV) systolic unloading via rapid removal of blood into a prosthetic ventricle during a single systole
C
Comparator
Normal left ventricular contraction
O
Outcome
Minimum rate of change of RV pressure (dP/dtmin) and the time constant (tau) of isovolumic RV pressure declinesurrogate

Acute left ventricular systolic unloading decreases the rate of right ventricular relaxation, demonstrating that RV relaxation is influenced by direct anatomic ventricular interaction.

Abstract

To determine whether direct ventricular interaction affects right ventricular (RV) relaxation, we compared the minimum rate of change of RV pressure (dP/dtmin) and the time constant, tau, of isovolumic RV pressure decline in open-chest, anesthetized pigs following a normal left ventricular (LV) contraction and an acutely unloaded LV contraction. Rapid removal of blood via the LV apex into a prosthetic ventricle during a single systole decreased the LV pressure-time integral 68.3% and peak systolic pressure 49.9% without changing RV end-diastolic conditions. Micromanometers measured ventricular chamber pressures during single RV isovolumic beats, which were produced by transient pulmonary artery occlusion in both the control and the LV-unloaded states. When the LV was unloaded, RV tau rose significantly from 41.7 +/- (SD) 7.1 to 49.8 +/- 9.4 ms, P < 0.005 (pericardium intact) and 42.9 +/- 10.8 to 51.8 +/- 13.9 ms, P < 0.005 (pericardium opened). Simultaneously, RV dP/dtmin decreased from -400.5 +/- 136.6 to -288.3 +/- 46.8 mmHg/s, P = 0.14 (pericardium intact), and -342.4 +/- 104.2 to -241.2 +/- 118.9 mmHg/s, P < 0.01 (pericardium opened). These data indicate that LV systolic unloading decreases the rate of RV relaxation. We conclude that RV relaxation is influenced by direct anatomic ventricular interaction.

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Brown et al. (1993) studied this question.

synapsesocial.com/papers/6a86a24201c90b39588b92b3https://doi.org/10.1152/ajpheart.1993.265.5.h1663
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