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Am J Physiol Heart Circ Physiol (December 19, 2008). doi:10.1152/ajpheart.00923.2008
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Submitted on August 22, 2008
Revised on November 21, 2008
Accepted on December 17, 2008

RIGHT VENTRICULAR FREE WALL CIRCUMFERENTIAL STRAIN REFLECTS GRADED ELEVATION IN ACUTE RIGHT VENTRICULAR AFTERLOAD

Eun Joo Cho1, Panupong Jiamsripong1, Anna M Calleja1, Mohsen S Alharthi1, Eileen M McMahon1, Bijoy K Khandheria1, and Marek Belohlavek1*

1 Mayo Clinic Arizona

* To whom correspondence should be addressed. E-mail: belohlavek.marek{at}mayo.edu.

Aims - This study was designed to evaluate the concurrent changes in the right ventricular free wall (RVFW) movement in experimentally induced, acute mild, moderate, and severe RV afterload conditions. Methods and Results - In 14 open-chest pigs (weight 43±4 kg) with preserved pericardia, acute mild (> 35 and < 50 mmHg), moderate (≥ 50 and ≤ 60 mmHg), and severe (> 60 mmHg) increases in RV systolic pressure (RVSP) were induced by constriction of the pulmonary artery. At each step, longitudinal, radial, and circumferential strains and strain rates were measured using a 2D speckle tracking method in both the RVFW and the interventricular septum (IVS). The mean RVSPs were 31.0±4.3 mmHg at baseline and 41.1±2.7 mmHg during mild, 52.7±3.4 mmHg during moderate, and 61.7±1.6 mmHg during severe afterload conditions. The RVFW circumferential strains showed significant differences among baseline, mild, moderate, and severe afterload conditions (-10.5±3.9, -8.3±3.3, -5.4±2.7, and -7.5±5.3%, respectively, P = 0.008) and had significant linear correlation with RVSP (r = 0.636, P < 0.001) if the severe condition was excluded. Conclusion - Decrease of the RVFW circumferential strain magnitude is the most distinct response in acute mild and moderate RV afterload that could aid in detection of clinical conditions associated with acutely increasing RV afterload.




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[Abstract] [Full Text] [PDF]




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