What question did this study set out to answer?

To evaluate the magnitude of left ventricular contribution to right ventricular systolic function and geometry in the intact heart during gradual reductions in left ventricular pressure.

December 1, 1989AJP Heart and Circulatory Physiology

Effects of left ventricular pressure reductions on right ventricular systolic performance

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Why the study?

Does a reduction in left ventricular pressure affect right ventricular systolic performance in an intact heart model?

Population

5 anesthetized pigs implanted with a left prosthetic ventricle

Comparison

Gradual decrease in left ventricular pressure… vs Baseline/steady state before LVP reduction

Design

Preclinical

Authors

ECE. ChowBrown University DFDavid J. FarrarHeart Failure / Cardiomyopathy

Discussion

Member takes

Implication

LV unloading minimally affects RV global performance despite septal shift in intact hearts; leaves open clinical relevance in diseased states.

Key Points

To evaluate the magnitude of left ventricular contribution to right ventricular systolic function and geometry in the intact heart during gradual reductions in left ventricular pressure.
Implanted a left prosthetic ventricle into anesthetized pigs (N=5) to progressively reduce left ventricular pressure while maintaining systemic arterial pressure.
Measured right ventricular global stroke work and regional dimensions (septum-to-free wall, anterior-to-posterior, and outflow tract segment length) during steady state and transient inferior vena cava occlusion.
A 90% reduction in peak systolic left ventricular pressure (from 102 ± 4 to 11 ± 3 mmHg) produced no changes in the right ventricular global stroke work curve or regional anterior-to-posterior and outflow tract pressure-dimension relationships.
Left ventricular pressure reduction induced parallel shifts in the septum-to-free wall dimension, showing a 16.6 ± 6.7% increase in the end-systolic intercept D(o) and a 16.5 ± 2.5% increase in the dimensional stroke work intercept D(o), with no significant slope changes.

Structured PICO

Does a reduction in left ventricular pressure affect right ventricular systolic performance in an intact heart model?

Population

5 anesthetized pigs implanted with a left prosthetic ventricle

Intervention

Gradual decrease in left ventricular pressure (LVP) while maintaining arterial systemic pressure

Comparator

Baseline/steady state before LVP reduction

Outcome

Right ventricular global and regional systolic function (measured in septum to free wall [RVSFW], anterior to posterior [RVAP] dimensions, and outflow tract segment length [RVSL])surrogate

Large reductions in left ventricular pressure affect right ventricular geometry due to septal shifting, but have a negligible net effect on overall right ventricular performance in the normal intact heart.

Cite This Study

Chow et al. (1989) studied this question.

synapsesocial.com/papers/6a7334040c0db29dfc2c1df2 https://doi.org/10.1152/ajpheart.1989.257.6.h1878

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Implication

LV unloading minimally affects RV global performance despite septal shift in intact hearts; leaves open clinical relevance in diseased states.

Effects of left ventricular pressure reductions on right ventricular systolic performance

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Effects of left ventricular pressure reductions on right ventricular systolic performance

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider