Right atrial ischemia exacerbates hemodynamic compromise associated with experimental right ventricular dysfunction.
To determine the importance of right atrial function with acute right ventricular dysfunction, sequential right ventricular and right atrial ischemia were induced in 15 dogs. Right ventricular ischemia resulted in right ventricular free wall dyskinesia, right ventricular dilation by ultrasound, elevated right ventricular filling pressure and paradoxic septal motion. There were decrements in right ventricular systolic pressure (28.9 +/- 5.5 to 25.5 +/- 4.6 mm Hg) (p less than 0.05 for these and all subsequent values) and stroke work (5.66 +/- 0.94 to 2.66 +/- 0.62 g.m/m2), resulting in reductions in left ventricular preload, systolic pressure (123 +/- 11 to 97 +/- 12 mm Hg) and stroke volume (24.2 +/- 4.3 to 19.1 +/- 5.2 ml). Right atrial contractility was augmented, as indicated by increases in peak A wave amplitude (ratio of peak A wave to mean right atrial pressure 1.22 +/- 0.02 to 1.46 +/- 0.3) and right atrial stroke work (0.11 +/- 0.02 to 0.25 +/- 0.05 g.m/m2). Right atrial ischemia depressed right atrial contraction, as indicated by decreased A wave amplitude (ratio of peak A wave to mean right atrial pressure 1.46 +/- 0.3 to 1.04 +/- 0.2) and stroke work (0.25 +/- 0.05 to 0.04 +/- 0.01 g.m/m2).(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110.
J A
JA
Goldstein
J S
JS
Tweddell
B
B
Barzilai
Y
Y
Yagi
A S
AS
Jaffe
J L
JL
Cox
D000704:Analysis of Variance; D000818:Animals; D016280:Atrial Function, Right; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004285:Dogs; D004452:Echocardiography; D006325:Heart Atria; D006352:Heart Ventricles; D006439:Hemodynamics; D009200:Myocardial Contraction; D016278:Ventricular Function, Right