Right ventricular function in patients with mitral stenosis.

Measurements of the right ventricular volume were performed using biplane cineangiocardiography on 17 patients with mitral stenosis, ranging in age from 34 to 62. The right ventricular end-diastolic volume index ranged from 69 to 130 ml/m2 (99 ± 18, mean ± SDM), and the right ventricular ejection fraction ranged from 0.33 to 0.69 (0.51 ± 0.08). There was an inverse relationship between the right ventricular end-diastolic volume index and the right ventricular ejection fraction (r=-0.52, p < 0.05). The cardiac index measured by the dye-dilution method ranged from 1.61 to 4.40 L/min/m2 (2.56 ± 0.72) and correlated with the right ventricular ejection fraction (r=0.78, p < 0.001). The right ventricular end-diastolic volume was larger in 11 patients with tricuspid regurgitation than those without (p < 0.05). It was larger in 11 patients with atrial fibrillation than those with sinus rhythm (p < 0.05). The right ventricular ejection fraction was lower in 8 patients with low cardiac output (0.47 ± 0.08) than those with normal cardiac output (0.47 ± 0.08 vs 0.55 ± 0.07, p < 0.05). It was lower in 11 patients with atrial fibrillation than those with a sinus rhythm (0.48 ± 0.07 vs 0.57 ± 0.09, p < 0.05). The right ventricular ejection fraction was also lower in 7 patients with restenosis of the mitral valve following a commissurotomy than those without a previous operation (0.46 ± 0.08 vs 0.55 ± 0.07, p < 0.02). The left ventricular ejection fraction was lower in 8 patients with low cardiac output than those with a normal one (0.49 ± 0.09 vs 0.56 ± 0.04, p < 0.05). These results indicate that the right ventricular function is abnormally depressed in patients with mitral stenosis associated with low cardiac output.