No abstract

The aim of the present study was to establish a new method to evaluate the right ventricular dimensions and volume. Biplane right ventriculography of steep left anterior oblique view (LAO) and right anterior oblique view perpendicular to LAO were performed in 32 patients. The right ventricular volume and ejection fraction calculated from the three axial dimensions of the right ventricular cavity (the septum-free wall dimension, the anterior-posterior dimension, and either the long axis dimension or the tricuspid valve-apex dimension at end-diastole and end-systole) were well correlated to those from Simpson's method. In conclusion, we developed a new method for estimating right ventricular dimensions and volume.

We examined whether differences in the location of myocardial hypertrophy influence the right ventricular diastolic function in patients with non-obstructive hypertrophic cardiomyopathy using cineangiography. Biplane right ventriculography was performed in 34 subjects (normal = 14, asymmetric septal hypertrophy = 9, apical hypertrophy = 11) during cardiac catheterization. In patients with asymmetric septal hypertrophy, compared with apical hypertrophy and normal groups, the indices of the right ventricular diastolic function including right ventricular peak filling rate and filling fraction of rapid filling phase were lower and the time to peak filling rate was prolonged. But in patients with apical hypertrophy, these indices were not significantly different compared with normal. There were no differences in right ventricular ejection fraction and cardiac index among the three groups. These data suggest that the location of the myocardial hypertrophy of the left ventricle is a significant factor affecting the right ventricular diastolic filling in non-obstructive hypertrophic cardiomyopathy.

ilated cardiomyopathy (DCM) is generally considered to be accompanied by both left and right ventricular dysfunction, 1,2 but in most studies only the function of the left ventricle (LV) has been analyzed, with less attention paid to the right ventricle (RV). One of the reasons is that the shape of the RV is complex and it is not easy to estimate RV volume and regional function. However, the RV ejection fraction (RVEF) is related to the capacity for exercise tolerance and to the prognosis in patients with severe LV failure such as an old myocardial infarction or dilated cardiomyopathy, 3-5 and therefore it is necessary to evaluate the RV function in such patients. Recently, we reported that RV angiography could be used to estimate the volume, ejection fraction (EF) and dimensional function of the chamber 6-9 and our aim in the present study was to examine the hemodynamics and dimensional function of the RV using this method in clinically well-controlled patients with DCM. Methods SubjectsTwenty-six patients underwent diagnostic catheterization: 13 (7 males, 6 females; mean age, 59.3 years (range, 16-75)) had chest pain and normal hemodynamics without Circulation Journal Vol. 68, October 2004 significant coronary artery stenosis, 13 (7 males, 6 females; mean age, 54.2 years (range, 22-73)) had DCM. DCM was diagnosed on the basis of exclusion of other causes of LV dysfunction, such as acute myocarditis, significant coronary artery stenosis, valvular disease and other secondary myocardial diseases. All patients were in normal sinus rhythm and New York Heart Association (NYHA) functional class II at catheter examination. Seven of the DCM patients had a past history of NYHA functional class IV. ProcedureRoutine left and right catheterization was performed using a standard technique. After LV cineangiography (right anterior oblique 30°) and coronary angiography, biplane RV cineangiography was performed with 35-mm cine film at a rate of 50 frames/s in a steep left anterior oblique view projection perpendicular to this projection using a Nishiya's catheter via the right femoral vein as previously reported. [6][7][8][9] We chose an angle for the left anterior oblique view in which the interventricular septum was seen best by biventriculography and in all patients it was 45°. In this projection, the 2 bent portions of the Nishiya's catheter appeared to overlap closely as if in a straight line. Shallow spontaneous breathing was permitted to avoid the Valsalva maneuver. Contrast medium (iopamidol 75.52%) was injected into the RV through the catheter at a rate of 12-13 ml/s for 3 s. Data AnalysisFrames from 1 cardiac cycle of the right ventriculogram from before the electrocardiographic P wave to behind the next P wave were analyzed. The RV silhouette on each frame of the biplane right ventriculogram was projected. Its Circ J 2004; 68: 933 -937 (Received April 26, 2004; revised manuscript received June 23, 2004; accepted July 6, 2004 Methods and ResultsBiplane right ventriculography was performed in 13 control subject...

The present study examined the influence of the extent of the ischemic area on right ventricular (RV) systolic function and the relation between the RV global and regional systolic function in patients with anteroseptal myocardial infarction (MI). Biplane right ventriculography was performed in 15 subjects as the control group, and 46 patients with anteroseptal MI as the MI group. Three dimensions of the RV (the long axis dimension [LA], the anterior-posterior dimension [AP] and the septum-free wall dimension [SF]) were examined to assess regional function The MI group had a larger right ventricular end-systolic volume index and lower right ventricular ejection fraction than the control group. The more proximal the coronary lesion, the lower was the ejection fraction of the RV in the MI group. The MI group had lower percent shortening (% shortening) of the SF than the control group, but there were no significant change in the % shortening of AP and LA between the groups. The results suggest that the degree of impairment of RV systolic function depends on the extent of the infarcted area, and that the impairment is mainly from a reduction in the %shortening of the SF.