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The relationship between longitudinal, lateral, and septal contribution to stroke volume in patients with pulmonary regurgitation and healthy volunteers

Stephensen, Sigurdur Sverrir LU ; Steding-Ehrenborg, Katarina; Munkhammar, Peter LU ; Heiberg, Einar LU ; Arheden, Håkan LU and Carlsson, Marcus LU (2014) In American Journal of Physiology: Heart and Circulatory Physiology 306(6). p.895-903
Abstract
Septal systolic motion is towards the left ventricle (LV) in healthy hearts. Patients with pulmonary regurgitation (PR) and right ventricular (RV) volume overload have systolic septal motion toward the RV. This may affect the longitudinal contribution from atrioventricular plane displacement (AVPD) and septal and lateral contribution to stroke volume (SV). The study aimed to quantify these contributions to SV in patients with PR. Cardiac magnetic resonance imaging was used for assessment of cardiac volumes. Patients (n = 30; age 9-59 yr) with PR due to surgically corrected tetralogy of Fallot and 54 healthy controls (age 10-66 yr) were studied. Longitudinal contribution to RVSV was 47 +/- 2% (means +/- SE) in patients with PR and 79 +/- 1%... (More)
Septal systolic motion is towards the left ventricle (LV) in healthy hearts. Patients with pulmonary regurgitation (PR) and right ventricular (RV) volume overload have systolic septal motion toward the RV. This may affect the longitudinal contribution from atrioventricular plane displacement (AVPD) and septal and lateral contribution to stroke volume (SV). The study aimed to quantify these contributions to SV in patients with PR. Cardiac magnetic resonance imaging was used for assessment of cardiac volumes. Patients (n = 30; age 9-59 yr) with PR due to surgically corrected tetralogy of Fallot and 54 healthy controls (age 10-66 yr) were studied. Longitudinal contribution to RVSV was 47 +/- 2% (means +/- SE) in patients with PR and 79 +/- 1% in controls (P < 0.001). Lateral contribution to RVSV and LVSV was 40 +/- 1 and 62 +/- 2% in patients and 31 +/- 1 and 36 +/- 1% in controls (P < 0.001 for both). Septal motion contributed to RVSV by 8 +/- 1% in patients and by 7 +/- 1% to LVSV in controls (P < 0.001). PR patients have decreased longitudinal contribution to RVSV and increased lateral pumping, resulting in larger outer volume changes and septal motion towards the RV. The changes in RV pumping physiology may be explained by RV remodeling resulting in lower systolic inflow of blood into the right atrium in relation to SV. This avoids the development of pendulum volume between the caval veins and right atrium, which would occur in PR patients if longitudinal contribution to SV was preserved. Decreased AVPD suggests that tricuspid annular excursion, a marker of RV function, is less valid in these patients. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
septal motion, radial and longitudinal function, pulmonary, regurgitation, RV volume load
in
American Journal of Physiology: Heart and Circulatory Physiology
volume
306
issue
6
pages
895 - 903
publisher
American Physiological Society
external identifiers
  • wos:000333333900012
  • scopus:84900543681
ISSN
1522-1539
DOI
10.1152/ajpheart.00483.2013
language
English
LU publication?
yes
id
952ec65e-7c8c-427d-b03f-953f466e8c4f (old id 4410626)
date added to LUP
2014-05-05 07:18:51
date last changed
2017-10-29 03:13:50
@article{952ec65e-7c8c-427d-b03f-953f466e8c4f,
  abstract     = {Septal systolic motion is towards the left ventricle (LV) in healthy hearts. Patients with pulmonary regurgitation (PR) and right ventricular (RV) volume overload have systolic septal motion toward the RV. This may affect the longitudinal contribution from atrioventricular plane displacement (AVPD) and septal and lateral contribution to stroke volume (SV). The study aimed to quantify these contributions to SV in patients with PR. Cardiac magnetic resonance imaging was used for assessment of cardiac volumes. Patients (n = 30; age 9-59 yr) with PR due to surgically corrected tetralogy of Fallot and 54 healthy controls (age 10-66 yr) were studied. Longitudinal contribution to RVSV was 47 +/- 2% (means +/- SE) in patients with PR and 79 +/- 1% in controls (P &lt; 0.001). Lateral contribution to RVSV and LVSV was 40 +/- 1 and 62 +/- 2% in patients and 31 +/- 1 and 36 +/- 1% in controls (P &lt; 0.001 for both). Septal motion contributed to RVSV by 8 +/- 1% in patients and by 7 +/- 1% to LVSV in controls (P &lt; 0.001). PR patients have decreased longitudinal contribution to RVSV and increased lateral pumping, resulting in larger outer volume changes and septal motion towards the RV. The changes in RV pumping physiology may be explained by RV remodeling resulting in lower systolic inflow of blood into the right atrium in relation to SV. This avoids the development of pendulum volume between the caval veins and right atrium, which would occur in PR patients if longitudinal contribution to SV was preserved. Decreased AVPD suggests that tricuspid annular excursion, a marker of RV function, is less valid in these patients.},
  author       = {Stephensen, Sigurdur Sverrir and Steding-Ehrenborg, Katarina and Munkhammar, Peter and Heiberg, Einar and Arheden, Håkan and Carlsson, Marcus},
  issn         = {1522-1539},
  keyword      = {septal motion,radial and longitudinal function,pulmonary,regurgitation,RV volume load},
  language     = {eng},
  number       = {6},
  pages        = {895--903},
  publisher    = {American Physiological Society},
  series       = {American Journal of Physiology: Heart and Circulatory Physiology},
  title        = {The relationship between longitudinal, lateral, and septal contribution to stroke volume in patients with pulmonary regurgitation and healthy volunteers},
  url          = {http://dx.doi.org/10.1152/ajpheart.00483.2013},
  volume       = {306},
  year         = {2014},
}