Maximal rate of fall of left ventricular pressure in cardiomyopathy and constrictive pericarditis.
The maximal rate of fall of left ventricular pressure (peak negative dp/dt) was measured in 4 patients with congestive cardiomyopathy (primary myocardial disease), in 5 patients with constrictive pericarditis and in 3 controls. Measurements were made at rest, with leg raising, after a bolus of 6 mug intravenous isoprenaline, and in patients with constrictive pericarditis during pulsus paradoxus. Peak negative dp/dt was 1810 +/- 234 mmHg/sec in controls; it was reduced in patients with constrictive pericarditis (1337 +/- 514 mmHg/sec) and greatly decreased in patients with congestive cardiomyopathy (812 +/- 190 mmHg/sec). There was close linear correlation between resting peak positive and peak negative dp/dt and there was little change with leg raising. Isoprenaline caused an increase in peak positive dp/dt, but there was only a small change in peak negative dp/dt. In patients with constrictive pericarditis, peak negative dp/dt varied during pulsus paradoxus: the linear relationship to peak positive dp/dt was maintained throughout the respiratory cycle. Peak negative dp/dt may be a useful index of myocardial function.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002118:Calcium / Q000378:metabolism; D002302:Cardiac Output; D009202:Cardiomyopathies / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006321:Heart / Q000187:drug effects / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007545:Isoproterenol / Q000494:pharmacology; D007866:Leg / Q000503:physiopathology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009068:Movement; D009206:Myocardium / Q000378:metabolism; D010494:Pericarditis, Constrictive / Q000378:metabolism / Q000503:physiopathology*; D013268:Stimulation, Chemical
D007545:Isoproterenol; D002118:Calcium