Disturbances of left-ventricular function in primary pulmonary hypertension
Dubiel, J.P.; Pyzik, Z.; Kolasińska-Kloch, W.
Acta Medica Polona 25(1-4): 73-85
1984
ISSN/ISBN: 0001-608X PMID: 6535385 Document Number: 239231
Left-ventricular function was studied in a group of 18 patients with primary pulmonary hypertension subdued to right- and left-sided catheterization. Left-sided ventriculography was performed in 8 patients. The group of patients showed typical disturbances of the hemodynamics of the pulmonary circulation and right heart ventricle. There was an enormous right-ventricular systolic overload: mean value of the systolic pulmonary artery pressure equalled 92.2 mmHg, and of the total pulmonary resistance - 1556 dyn s cm-5. Left-ventricular function was evaluated based on the indices which characterized the ventricle as the pump as well as on the quantitative angiographic parameters. The indices of left-ventricular function of patients with primary pulmonary hypertension were compared with those found in 16 controls. Mean values of cardiac (.hivin.x = 2.38 .+-. 0.98 l/m/m2), stroke volume (.hivin.x = 27.9 .+-. 10.0 ml/stroke/m2) and left-ventricular work (.hivin.x = 3.34 .+-. 1.57 kgm/min/m2) indices as well as of the ejection fraction (.hivin.x = 50.7 .+-. 9.8%) were lower in patients than in the controls. The end-systolic volume index rose (.hivin.x = 40.6 .+-. 5.9 ml/m2). Left-ventricular end-diastolic pressure was within the normal range (.hivin.x = 7.5 .+-. 3.8 mmHg). Both groups failed to differ by the mean values of the end-diastolic volume index and of the triple product. The impairment of left-ventricular cardiac function in primary pulmonary hypertension is indicated. They do also endorse the thesis about simultaneously limited compensatory mechanism of Frank and Starling because of impeded filling of left-ventricle due to high pulmonary resistance.