Volume overloading and the right-ventricular function in healthy persons and patients with primary congestive heart failure
Dubiel, J.P.; Dubiel, J.S.; Horzela, T.
Folia Medica Cracoviensia 22(1): 21-38
1980
ISSN/ISBN: 0015-5616 PMID: 7439839 Document Number: 163570
The influence of volume overloading on right ventricular function and pulmonary circulation was investigated in 7 healthy subjects and in 10 patients with primary congestive cardiomyopathy. Three meters were used to evaluate right ventricular function: pump function, contractility indexes and systolic time intervals. A statistically significant increase of right atrial pressure, right ventricular pressure, pulmonary artery pressure and pulmonary artery wedge pressure was observed in both groups. The mean absolute values of pressure increase were greater in the group of patients but percentage values were similar in both groups compared. In both groups right atrial pressure, right ventricular end-diastolic pressure and pulmonary artery wedge pressure were increased. Dextran in the group of healthy subjects caused a statistically insignificant increase of cardiac index and stroke volume index, and a shifiting of right ventricular work point slightly to the right on ascending heart function curve. Total right ventricular contraction time, right ventricular pre-ejection period, right ventricular ejection time and right ventricular ejection time-index showed a tendency toward prolongation. Maximum dP-(dt) P [1st derivative of left ventricular pressure] increased (statistically insignificant). Two different responses of volume overloading were observed among the patients with primary congestive cardiomyopathy: patients with normal right ventricular end-diastolic pressure and normal pulmonary pressure showed similar changes as healthy subjects; and patients with increased preload (elevated right ventricular end-diastolic pressure) and increased afterload (pulmonary artery pressure) reacted to volume overloading with tendency to decreasing cardiac index, stroke volume index and maximum dP (dt) P. Right ventricular work point was shifted to the descending heart function curve.