Abnormal right ventricular filling in patients with dilated cardiomyopathy

Doppler echocardiograms of the tricuspid and mitral valves were recorded along with the electrocardiogram and respiration in six patients with dilated cardiomyopathy and 20 normal children. There was significant respiratory variation in right ventricular filling in the patients with dilated cardiomyopathy. Four variables of early diastolic right ventricular filling increased with inspiration: the peak E velocity (mean increase 55%, p < 0.05), the E/total area (mean increase 32%, p < 0.001), the E/A area (mean increase 74%, p < 0.001), and peak E/A ratio (mean increase 72%, p < 0.01), whereas the peak A velocity did not change significantly and the A/total decreased (mean decrease 27%, p < 0.001). Thus, abnormalities of right ventricular filling worsened during expiration and improved with inspiration. Inspiration enhances right ventricular venous return and thus improves indices of right ventricular filling in patients with cardiomyopathy.