Determinants of hemodynamic compromise with severe right ventricular infarction.

Abstract

To elucidate determinants of hemodynamic compromise in patients with acute right ventricular (RV) infarction, we studied 16 patients with hemodynamically severe RV infarction by right heart catheterization and two-dimensional ultrasound. Severe RV systolic dysfunction, evident by ultrasound in all patients as RV dilatation and depressed RV free wall motion, was associated with a broad sluggish RV

Right atrial function in hypertensive patients: effects of antihypertensive therapy

“…RV diastolic dysfunction was indicated by the prolonged RV-IVRT reflecting the effects of intrinsic RV myocardial stiffness. 8 The diastolic abnormality described should not be unexpected. Hypertension increases left ventricular intrinsic myocardial stiffness.…”

“…This response constitutes an important hemodynamic compensatory mechanism. 8,9 Many factors are involved in these changes in hypertensives. First, an increased pulmonary arteriolar resistance should be involved which is of mechanical or vasomotor origin.…”

“…First, an increased pulmonary arteriolar resistance should be involved which is of mechanical or vasomotor origin. [7][8][9] Increased afterload may also explain the impaired RV relaxation and the increased 'RA kick'. Based on the relationship that exists between left atrial and RA function an alternative explanation might be a common mechanism that produces vasoconstriction in the systemic and pulmonary circulation.…”

“…7 Under these circumstances the status of RA function is an important determinant of RV performance and haemodynamic compromise. 8 The RV and RA function has been assessed in experimental and clinical conditions. [7][8][9][10] Noninvasive RA function has been performed with echocardiography by means of RA volume measurements.…”

“…8 The RV and RA function has been assessed in experimental and clinical conditions. [7][8][9][10] Noninvasive RA function has been performed with echocardiography by means of RA volume measurements. [11][12][13] Indirectly, RA function can also be evaluated with the use of pulsed Doppler echocardiography by means of trans-tricuspid flow velocity measurements in a similar manner with that used for the estimation of left atrial function.…”