1012 Cardiac surgery results in anterior translocation of the left ventricle in systole and tethering of the right ventricular free wall – an explanation for post-operative paradoxical septal motion

To analyze the interaction between the right and left ventricle, we developed a model that consists of three functional elastic compartments (left ventricular free wall, septal, and right ventricular free wall compartments). Using 10 isolated blood-perfused canine hearts, we determined the end-systolic volume elastance of each of these three compartments. The functional septum was by far stiffer for either direction [47.2 +/- 7.2 (SE) mmHg/ml when pushed from left ventricle and 44.6 +/- 6.8 when pushed from right ventricle] than ventricular free walls [6.8 +/- 0.9 mmHg/ml for left ventricle and 2.9 +/- 0.2 for right ventricle]. The model prediction that right-to-left ventricular interaction (GRL) would be about twice as large as left-to-right interaction (GLR) was tested by direct measurement of changes in isovolumic peak pressure in one ventricle while the systolic pressure of the contralateral ventricle was varied. GRL thus measured was about twice GLR (0.146 +/- 0.003 vs. 0.08 +/- 0.001). In a separate protocol the end-systolic pressure-volume relationship (ESPVR) of each ventricle was measured while the contralateral ventricle was alternatively empty and while systolic pressure was maintained at a fixed value. The cross-talk gain was derived by dividing the amount of upward shift of the ESPVR by the systolic pressure difference in the other ventricle. Again GRL measured about twice GLR (0.126 +/- 0.002 vs. 0.065 +/- 0.008). There was no statistical difference between the gains determined by each of the three methods (predicted from the compartment elastances, measured directly, or calculated from shifts in the ESPVR). We conclude that systolic cross-talk gain was twice as large from right to left as from left to right and that the three-compartment volume elastance model is a powerful concept in interpreting ventricular cross talk.

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Association of epicardial fat thickness with left ventricular diastolic function parameters in a community population

10.21203/rs.3.rs-171598/v2 ◽

2021 ◽

Author(s):

Wei Ma ◽

Baowei Zhang ◽

Ying Yang ◽

Litong Qi ◽

Jin Zhou ◽

...

Keyword(s):

Confidence Interval ◽

Right Ventricular ◽

Diastolic Function ◽

Ventricular Free Wall ◽

Free Wall ◽

Right Ventricular Free Wall ◽

Community Population ◽

The Mean ◽

The Right ◽

The Relationship

Abstract Purpose We examined the relationship between EFT measured by echocardiography and LV diastolic function parameters in a Beijing community population. Methods We included 1004 participants in this study. Echocardiographic parameters including E and A peak velocity, the early diastolic velocities (e’) of the septal and lateral of mitral annulus using tissue doppler imaging, E/e’, and EFT, were measured. EFT1 was measured perpendicularly on the right ventricular free wall at end-diastole in the extension line of the aortic root. EFT2 was the maximum thickness measured perpendicularly on the right ventricular free wall at end-diastole. Multivariate linear regression was used to analyze the relationship between EFT and the mean e’ and E/e’. Results The mean age of the participants was 63.91 ± 9.02 years old (51.4% men). EFT1 and EFT2 were negatively correlated with e’ lat, e’ sep, and e’ mean (p < 0.05), and positively correlated with E/e’ lat, E/e’ sep, and E/e’ mean. Multivariate regression analysis showed that EFT1 and EFT2 were independently and negatively correlated with e’ mean (EFT1: β = −0.089 [95% confidence interval = − 0.177, − 0.000, p = 0.050]; EFT2: β = −0.078 [95% confidence interval = − 0.143, − 0.012, p = 0.020]). There were no interactions between EFT and any covariates, including age or heart groups, sex, BMI, or presence of hypertension, diabetes, or coronary heart disease in relation to LV diastolic dysfunction. Conclusions EFT was negatively and independently correlated with e’ mean, suggesting that more attention to this type of adipose fat is required for cardiovascular disease therapy.

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Progressive right ventricular outflow tract fibrosis after repair of tetralogy of Fallot

Cardiology in the Young ◽

10.1017/s1047951120002164 ◽

2020 ◽

Vol 30 (9) ◽

pp. 1366-1367

Author(s):

Gauri R. Karur ◽

Wadi Mawad ◽

Lars Grosse-Wortmann

Keyword(s):

Cardiac Magnetic Resonance ◽

Right Ventricular ◽

Tetralogy Of Fallot ◽

T1 Mapping ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Ventricular Free Wall ◽

Free Wall ◽

Right Ventricular Free Wall ◽

The Right

AbstractObjectives:The objective of this study was to determine the evolution of fibrosis over time and its association with clinical status.Methods:Children with repaired tetralogy of Fallot who had undergone at least two cardiac magnetic resonance examinations including T1 mapping at least 1 year apart were included.Results:Thirty-seven patients (12.7 ± 2.6 years, 61% male) were included. Right ventricular free wall T1 increased (913 ± 208 versus 1023 ± 220 ms; p = 0.02). Baseline cardiac magnetic resonance parameters did not predict a change in imaging markers or exercise tolerance. The right ventricular free wall per cent change correlated with left ventricular T1% change (r = 0.51, p = 0.001) and right ventricular mass Z-score change (r = 0.51, p = 0.001). T1 in patients with late gadolinium enhancement did not differ from the rest.Conclusion:Increasing right ventricular free wall T1 indicates possible progressive fibrotic remodelling in the right ventricular outflow tract in this pilot study in children and adolescents with repaired tetralogy of Fallot. The value of T1 mapping both at baseline and during serial assessments will need to be investigated in larger cohorts with longer follow-up.

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