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1 Division of Cardiothoracic Surgery, Department of Surgery, and 2 Center for Emerging Cardiovascular Technologies, Duke University Medical Center, Durham, North Carolina 27710
By limiting filling, abnormalities of right ventricular (RV) diastolic function may impair systolic function and affect adaptation to disease. To quantify diastolic RV pressure-volume relations and myocardial compliance (MC), a new sigmoidal model was developed. RV micromanometric and sonomicrometric data in alert dogs at control (n = 16) and under surgically induced subacute (2-5 wk) RV pressure overload (n = 6), volume overload (n = 7), and ischemia (n = 6) were analyzed. The conventional exponential model detected no changes from control in the passive filling pressure-volume (Ppf-V) relations. The new sigmoidal model revealed significant quantifiable changes in Ppf-V relations. Maximum RV MC (MCmax), attained during early filling, is reduced from control in pressure overload (P = 0.0016), whereas filling pressure at maximum MC (PMCmax) is increased (P = 0.0001). End-diastolic RV MC increases significantly in volume overload (P = 0.0131), whereas end-diastolic pressure is unchanged. In ischemia, MCmax is decreased (P = 0.0102), with no change in PMCmax. We conclude that the sigmoidal model quantifies important changes in RV diastolic function in alert dog models of pressure overload, volume overload, and ischemia.
diastole; dynamics; heart failure; myocardial compliance; right ventricle
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