[The influence of the right or left ventricular pressure overload on right and left ventricular diastolic behaviors as examined by pulsed Doppler echocardiography].
The influence of morphological and dynamic changes in the interventricular septum (IVS) on right ventricular (RV) and left ventricular (LV) fillings in cases of LV or RV pressure overload was evaluated. Using pulsed Doppler echocardiography, LV and RV inflow signals were recorded in 20 healthy subjects, in 36 cases of chronic pulmonary disease (CPD) with pulmonary hypertension, and in 46 cases of essential hypertension (HT). Two-dimensional short-axis echocardiograms were recorded at end-diastole (ED) and end-systole (ES) in the healthy subjects and in the cases with CPD. M-mode echocardiograms of the LV were recorded in the healthy subjects and in the cases with HT. We measured (1) the ratio of the peak velocity of inflow due to atrial contraction to that of rapid inflow (A/R), (2) the deceleration half-time of rapid inflow (delta TD), (3) the corrected radius of curvature of the IVS at ED and ES, (4) the % change of lengthening (CL) of 16 radial grids using a fixed method on the ED and ES short-axis images, and (5) the IVS end-diastolic thickness (IVSEDTh). The results were as follows: 1. In the patients with CPD, (1) the diastolic behavior was impaired not only in the RV, but in the LV as well, as shown by the increased A/R and prolonged delta TD in both ventricles, (2) the IVS was flattened at ED, as shown by the decreased corrected radius of the curvature, (3) the regional wall motion of the IVS was impaired, as shown by the decreased CL of the IVS. 2. In the patients with HT, (4) the RV diastolic filling was not impaired, (5) the LV A/R correlated with IVSEDTh, but the RV A/R did not correlate with IVSEDTh. We concluded that RV pressure overload interferes with IVS motion during diastole, and that the regional impairment of diastolic behavior of the IVS causes impairment of LV diastolic filling. Furthermore, the increased IVS wall thickness due to LV pressure overload has a little or no influence on the RV inflow pattern because the RV free wall was so distensible as to overcome the effect of increased IVS stiffness.
D000368:Aged; D001783:Blood Flow Velocity; D002908:Chronic Disease; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006346:Heart Septum / Q000473:pathology* / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008171:Lung Diseases / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction