title: Right ventricular dysfunction during coronary artery occlusion: pressure-volume analysis using conductance catheters during coronary angioplasty.
abstract: OBJECTIVE
  To study the effects of coronary artery occlusion on the pressure-volume relations of the right ventricle.
  
  
  METHODS
  Right ventricular pressure-volume cycles were studied using conductance catheters and micromanometers in 19 subjects undergoing coronary angioplasty in a tertiary referral cardiac centre.
  
  
  RESULTS
  Catheter occlusions of either the left anterior descending coronary artery or the right coronary artery were associated with a decline in stroke work (mean change (SD): left-13.3 (15.8)%, p = 0.008; right -13.5(16.5)%, p = 0.04). Two patterns of change were evident: an upward shift usually associated with occlusion in the left coronary artery, and a rightward shift in the right coronary artery. In the former there was an increase in maximum ventricular volume (mean change: 3.0(2.7)%, p = 0.004) and in minimum ventricular volume (mean change: 2.3(2.7)%, p = 0.01) and a fall in peak pressure (mean change: -4.8 (5.1)%, p = 0.04). In the latter there was an increase in peak pressure (mean change 9.9(16.3)%, p = 0.04) and an increase in minimum ventricular volume (mean change 3.7(5.0)%, p = 0.02) leading to a fall in stroke volume (mean change -13.3(15.8)%, p = 0.008).
  
  
  CONCLUSIONS
  Occlusion of the left anterior descending coronary artery or the right coronary artery is associated with a decline in right ventricular work. However, different patterns of change in indices of preload and afterload lead to different effects on overall right ventricular pump function.
authors.affiliation: Royal Brompton Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Bishop
authors.forename: P
authors.initials: P
authors.lastname: White
authors.forename: P
authors.initials: P
authors.lastname: Groves
authors.forename: R
authors.initials: R
authors.lastname: Chaturvedi
authors.forename: C
authors.initials: C
authors.lastname: Brookes
authors.forename: A
authors.initials: A
authors.lastname: Redington
authors.forename: P
authors.initials: P
authors.lastname: Oldershaw
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007432:Intraoperative Period; D013318:Stroke Volume; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*; D017725:Ventricular Pressure