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[Function of the right ventricle in patients with dilated cardiomyopathy]
R Unterberg1, S Dacian, W Rudolph
1Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München.
Insights
In dilated cardiomyopathy (DCM), the right ventricle dilates less than the left, but its ejection fraction is reduced more significantly in some patients. This highlights potential right ventricular dysfunction in DCM.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Pathophysiology
Context:
- Dilated cardiomyopathy (DCM) is a complex condition affecting heart muscle.
- Understanding right ventricular (RV) involvement is crucial for prognosis.
- Biplane cineventriculography is a key imaging technique for assessing ventricular function.
Purpose:
- To analyze right-ventricular size and function in DCM patients.
- To investigate the relationship between RV and left-ventricular (LV) dimensions and function.
- To compare RV and LV parameters in DCM patients versus normal controls.
Summary:
- DCM patients showed less pronounced RV dilatation (RVEDVI) compared to LV dilatation (LVEDVI).
- Right-ventricular ejection fraction (RVEF) was less reduced than left-ventricular ejection fraction (LVEF) overall, but markedly more reduced in 6/57 patients.
- Good correlation found between RV and LV stroke volumes, moderate correlation for ejection fractions and volumes.
Impact:
- Reveals differential ventricular involvement in DCM, with potential for significant RV dysfunction.
- Suggests RV myocardial biopsy may be useful in specific cases of suspected DCM with disproportionate RV impairment.
- Informs clinical assessment and management strategies for dilated cardiomyopathy.
Abstract:
To analyze right-ventricular size and function and their relationship to left-ventricular dimensions in patients with dilated cardiomyopathy (DCM), biplane cineventriculography was performed in 57 patients. The results were compared to 15 normals (N). In patients dilatation of the right ventricle (RVEDVI: DCM: 126.5 +/- 41.4 ml/m2, N: 90.5 +/- 9.2 ml/m2, 2 p < 0.05) was less pronounced than dilatation of the left ventricle (LVEDVI: DCM: 136.0 +/- 45.8 ml/m2, N: 76.7 +/- 7.9 ml/m2, 2 p < 0.05). Left-ventricular ejection fraction (LVEF: DCM: 36.1 +/- 10.2%, N: 64.4 +/- 3.8%, 2 p < 0.05) was more reduced than right-ventricular ejection fraction (RVEF: DCM: 39.7 +/- 11.5%, N: 58.3 +/- 3.3%, 2 p < 0.05). Concerning the individual patient, a good correlation was found between right- and left-ventricular stroke volume (r = 0.74), whereas ejection fraction (r = 0.58), enddiastolic (r = 0.52) and endsystolic volume (r = 0.55) of the left and right ventricle correlated only moderately. Twenty-three of the 57 patients showed pronounced differences between right- and left-ventricular ejection fraction. The difference RVEF-LVEF was < = -10% in six patients, i.e., right-ventricular ejection fraction was markedly more reduced than left-ventricular ejection fraction. Right-ventricular myocardial biopsy was performed in five of these six patients with histologic evidence of dilated cardiomyopathy and, also, no signs of right-ventricular dysplasia (no lipomatous tissue replacement).(ABSTRACT TRUNCATED AT 250 WORDS)