TY - JOUR
T1 - Impact of Preload and Afterload on Global and Regional Right Ventricular Function and Pressure
T2 - A Quantitative Echocardiography Study
AU - Kjaergaard, Jesper
AU - Snyder, Eric M.
AU - Hassager, Christian
AU - Oh, Jae K.
AU - Johnson, Bruce D.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/5
Y1 - 2006/5
N2 - Background: Several quantitative echocardiographic measures of global and regional right ventricular (RV) function have been proposed, but knowledge of the impact of increases in preload and afterload is limited. Methods: Seventeen healthy participants were exposed to increased preload by rapid infusion of 30 mL/kg of saline over 15 minutes, and to increased afterload simulated in an 16- to 18-hour stay in a controlled hypoxic environment (fractional concentration of oxygen in inspired gas = 12.3%). Two-dimensional, Doppler, and Doppler tissue echocardiography evaluations were performed to evaluate global and regional RV function, with changes evaluated by paired analysis. Results: Peak tricuspid regurgitation velocity increased in both conditions, whereas the RV end-diastolic diameter and acceleration time of the pulmonary forward flow only increased with increased preload and afterload, respectively. Estimates of RV function and contractility remained stable: no changes in the RV isovolumic acceleration (1.6 ± 0.6 vs 1.6 ± 0.4 and 1.3 ± 0.4 cm/s2) or tricuspid annular plane systolic excursion (2.5 ± 0.4 vs 2.5 ± 0.3 and 2.6 ± 0.3 cm) were seen (baseline compared with increased afterload and preload, respectively). The RV index of myocardial performance was increased with increased afterload (0.26 ± 0.08 vs 0.34 ± 0.13, P < .05), whereas no changes with increased preload were seen. Changes in loading conditions did not affect the regional strain. Conclusion: Moderate volume and pressure loading of the RV induces detectable changes in the RV pressure and morphology. Modern echocardiographic measures of systolic RV function seem stable with moderate increases in preload and afterload.
AB - Background: Several quantitative echocardiographic measures of global and regional right ventricular (RV) function have been proposed, but knowledge of the impact of increases in preload and afterload is limited. Methods: Seventeen healthy participants were exposed to increased preload by rapid infusion of 30 mL/kg of saline over 15 minutes, and to increased afterload simulated in an 16- to 18-hour stay in a controlled hypoxic environment (fractional concentration of oxygen in inspired gas = 12.3%). Two-dimensional, Doppler, and Doppler tissue echocardiography evaluations were performed to evaluate global and regional RV function, with changes evaluated by paired analysis. Results: Peak tricuspid regurgitation velocity increased in both conditions, whereas the RV end-diastolic diameter and acceleration time of the pulmonary forward flow only increased with increased preload and afterload, respectively. Estimates of RV function and contractility remained stable: no changes in the RV isovolumic acceleration (1.6 ± 0.6 vs 1.6 ± 0.4 and 1.3 ± 0.4 cm/s2) or tricuspid annular plane systolic excursion (2.5 ± 0.4 vs 2.5 ± 0.3 and 2.6 ± 0.3 cm) were seen (baseline compared with increased afterload and preload, respectively). The RV index of myocardial performance was increased with increased afterload (0.26 ± 0.08 vs 0.34 ± 0.13, P < .05), whereas no changes with increased preload were seen. Changes in loading conditions did not affect the regional strain. Conclusion: Moderate volume and pressure loading of the RV induces detectable changes in the RV pressure and morphology. Modern echocardiographic measures of systolic RV function seem stable with moderate increases in preload and afterload.
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U2 - 10.1016/j.echo.2005.12.021
DO - 10.1016/j.echo.2005.12.021
M3 - Article
C2 - 16644434
AN - SCOPUS:33646531193
SN - 0894-7317
VL - 19
SP - 515
EP - 521
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 5
ER -