[Effect of acute short-term ischemia during PTCA on the function of the right ventricle]

To determine whether a transient ischemia of the right ventricle leads to right ventricular impairment and whether RV function can also be influenced by septal ischemia caused by an occlusion of the left anterior descending coronary artery (LAD), RV function before and at the end of 60 s of ischemia during PTCA was assessed in 15 patients with single-vessel disease of either the right coronary artery (RCA, n = 10) or the LAD (n = 5). The RV-enddiastolic pressure and the pulmonary capillary wedge pressure (PCW) were recorded continuously. The RV ejection fraction was determined from ventriculograms performed before and during coronary occlusion. An increase of RVEDP from 3.7 +/- 1.2 to 8.3 +/- 1.8 mm Hg (p less than or equal to 0.001) and a decrease of the RV-ejection fraction from 52 +/- 3 to 33 +/- 8% (p less than or equal to 0.001) occurred during RCA occlusion with a predominant ischemia of the RV free wall only, and not during LAD occlusion with left ventricular and septal ischemia. The extent of the RV dysfunction was independent of an additional increase of RV afterload (PCW increase). Comparable to ischemic effects on left ventricular function, an acute right ventricular myocardial ischemia results in a severe RV contractile failure.