The septal motor of biventricular function

Saleh, Saleh; Liakopoulos, Oliver J.; Buckberg, Gerald D.

doi:10.1016/j.ejcts.2006.02.048

Cited by 112 publications

(124 citation statements)

References 41 publications

Supporting

Mentioning

119

Contrasting

Unclassified

Order By: Relevance

“…Ischemic LV disease may eventually result in myocardial remodeling, morphologically seen as chamber dilatation (26) which can lead to increased transversing of the oblique muscle fibers in the interventricular septum (19,27,28). Hence, the observed RV intraventricular flow alteration could in part be explained by altered properties of the shared interventricular septum in the patients with higher LVEDVI.…”

Section: Discussionmentioning

confidence: 99%

4D flow MRI can detect subtle right ventricular dysfunction in primary left ventricular disease

Fredriksson

Svalbring

Eriksson

et al. 2015

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Methods4D flow and morphological 3T MRI data were acquired in 22 patients with mild ischemic heart disease, that were stratified into two groups based on LV end-diastolic volume index (EDVI): lower-LVEDVI and higher-LVEDVI, as well as in 11 healthy controls. The RV volume was segmented at end-diastole (ED) and end-systole (ES).Pathlines were emitted from the ED volume and traced forwards and backwards in time to ES. The blood volume was separated into flow components. The Direct Flow (DF) component was defined as RV inflow passing directly to outflow. The kinetic energy (KE) of the DF component was calculated. Echocardiographic conventional RV indices were also assessed. ResultsThe higher-LVEDVI group had larger LVEDVI and lower LV ejection fraction (98±32 ml/m 2 ; 48±13 %) compared to the healthy (67±12, P=0.002; 64±7, P<0.001) and lower-LVEDI group (62±10; 68±7, both P<0.001). The RV 4D flow specific measures "DF/EDV volume-ratio" and "DF/EDV KE-ratio at ED" were lower in the higher-LVEDVI group (38±5 %; 52±6 %) compared to the healthy (44±6; 65±7, P=0.018 and P<0.001) and lower-LVEDVI groups (44±6; 64±7, P=0.011 and P<0.001). There was no difference in any of the conventional MRI and echocardiographic RV indices between the three groups.4 ConclusionWe found that in primary LV disease, mild impairment of RV function can be detected by 4D flow specific measures, but not by the conventional MRI and echocardiographic indices.

show abstract

Section: Discussionmentioning

confidence: 99%

4D flow MRI can detect subtle right ventricular dysfunction in primary left ventricular disease

Fredriksson

Svalbring

Eriksson

et al. 2015

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…such constriction may not allow delivery of enough contractile force to ensure adequate cardiac output when pulmonary vascular resistance is increased. 19 In the present study, there were no significant differences in several outcome measures such as in-hospital mortality, cerebrovascular diseases, serum creatinine concentration and atrial fibrillation/flutter, between subjects who had log 10 RPP of 4.0 or above and those who had below the cut-off value. However a longer follow up might show significant differences in outcome measures between these two groups.…”

Section: Resultsmentioning

confidence: 68%

“…therefore these results further confirm the central role that the septum plays in the determination of ventricular workload and oxygen demand, and saleh et al rightly described it as "the motor of biventricular function". 19 the septum is a complex structure that accounts for up to 40% of LV output. 19 During systole, the septum twists and shortens causing reduction in ventricular volume and forceful ejection of blood out of both ventricular cavities.…”

Section: Resultsmentioning

confidence: 99%

“…19 the septum is a complex structure that accounts for up to 40% of LV output. 19 During systole, the septum twists and shortens causing reduction in ventricular volume and forceful ejection of blood out of both ventricular cavities. In the case of the right ventricle, the septum seems to account for the major force of ejection, especially when there is pulmonary hypertension.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The significance of rate pressure product in heart failure patients

Karaye

Akintunde

2015

ICFJ

View full text Add to dashboard Cite

Introduction: The rate pressure product (RPP) is a strong determinant of myocardial oxygen consumption, and relates strongly to important indices for morbidity and cardiovascular mortality. Its significance in Black-African subjects with heart failure (HF) has however not been well described. This study therefore aimed to assess the significance of RPP among admitted HF patients in 2 Nigerian centres.Methods: Admitted HF patients in the 2 centres were serially recruited after satisfying all inclusion criteria. RPP was calculated by multiplying heart rate by systolic blood pressure at admission. Subjects were classified into 2 groups based on RPP <10,000 (log10 <4.0) (group 1) or above (group 2), which is a cut-off value above which there is increased risk of myocardial ischemia.Results: 100 subjects were recruited from the 2 centres with a mean age of 47.3+/-19.5 years, and 53% were females. 35% of the subjects were in group 1 while 65% were in group 2. N-Terminal B-type Natriuretic Peptide (NTBNP), serially measured in only 37 subjects (12 in group 1; 25 in group 2), was significantly higher in group 1 as compared with group 2 (p=0.016). Group 1 also had lower interventricular septal thickness(IVST) (p=0.007) as compared with group 2 subjects. RPP correlated strongly with IVST (r=+0.510, p<0.001), left ventricular posterior wall thickness (LVPWT) (r=+0.399, p<0.001) and LV end-diastolic dimension (LVEDD) (r=-0.202, p=0.045). Log10 >4.0 was strongly associated with IVST (95%confidence interval (CI): 1.061-1.528, p=0.009) and NT-BNP (CI:0.999-1.000, p=0.026). There was however no significant relationship (p>0.05) between RPP and in-hospital mortality, severity of dyspnoea, gender, age, body weight, LV ejection fraction or presence of atrial fibrillation/flutter.Conclusion: This study confirms the close relationship that exists between a determinant of myocardial oxygen consumption (RPP), and indices for LV wall tension (IVST, LVEDD and NT-BNP), in Black-Africans with HF.

show abstract

“…Right ventricular performance and coronary perfusion may be adversely affected by altered LV hemodynamics, thereby suggesting the role of ventricular interdepedance [22] . This ventricular interdependence may also be due to common septal abnormality in the form of abnormally increased septal thickness, disruption of fiber orientation leading to septal dysfunction [23]. LV dilatation associated with LVH and LVDD in a limited pericardial compartment may also cause right ventricular diastolic dysfunction [24].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Left Ventricular Hypertrophy and Altered Geometry in Patients with Right Ventricular Diastolic Dysfunction

Brindisi¹,

Sharma²,

Matteo³

2011

J Clinic Experiment Cardiol

View full text Add to dashboard Cite

Background: Left ventricular diastolic dysfunction (LVDD) associated with left ventricular hypertrophy (LVH) has been reported to play a major role in cardiovascular heart failure. Although, right ventricular diastolic dysfunction (RVDD) in patients with LVH was known to be clinically relevant, no systematic study had been performed regarding this relationship between left ventricular (LV) geometry associated with LVH and RVDD. The goal of this study was to evaluate an association between RVDD; LVDD, LVH and LV altered geometry for early diagnosis of heart failure. Methods and Results:Out of 426 patients, 396 patients (93%) were found to have both RVDD and LVDD. In this cohort, LV concentric geometry (LVCG) was identified in 138 patients (32.3%). RVDD and LVDD were diagnosed by measurement of E/A and tissue doppler imaging (E'/A') for mitral and tricuspid valves. The mean value of mitral E/A in the LVCG group was lower than that of controls; 0.63±0.03 vs. 1.44±0.03, p<0.02. Mitral E'/A' was also lower in LVCG than that of controls; 0.60±0.02 vs. 1.36±0.03, p<0.01. Similarly, E/A of Tricuspid valve in patients with LVCG was found to be lower than E/A of Tricuspid valve of controls; 0.52±0.07 vs. 0.69±0.02, p<0.001 and E'/A' of tricuspid valve was lower than that of controls; 0.44±0.02 vs. 0.63±0.06, p<0.05. Conclusions:This study demonstrated that simple doppler trans-valvular inflow parameters and tissue doppler imaging may identify patients with biventricular diastolic dysfunction. This finding was more often observed in patients with LV concentric geometry, a pattern associated with an increased risk of cardiovascular events.

show abstract

The septal motor of biventricular function

Cited by 112 publications

References 41 publications

4D flow MRI can detect subtle right ventricular dysfunction in primary left ventricular disease

4D flow MRI can detect subtle right ventricular dysfunction in primary left ventricular disease

The significance of rate pressure product in heart failure patients

The Prevalence of Left Ventricular Hypertrophy and Altered Geometry in Patients with Right Ventricular Diastolic Dysfunction

Contact Info

Product

Resources

About