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• W2081185698 abstract "Introduction: The right and left ventricles (RV, LV) share a common septum, and are enclosed in a relatively nondistensible pericardium. Changes in function in the RV can affect that of the LV, and vice versa. This interaction is termed ventricular interdependence (VI) and is characterized by diastolic pressure equilibration. When VI is evident, volume unloading of the RV increases LV diastolic volume and stroke work. Hence, establishing that VI is contributing to the hemodynamic alterations in heart failure becomes an important goal. This study was conducted to: a) establish the relative frequency of VI in patients undergoing hemodynamic evaluation, and b) characterize the conditions that predispose to VI. Methods: Hemodynamic and echocardiographic data were retrospectively analyzed in 526 patients who underwent right and left cardiac catheterization. VI was considered to be present when: a) right atrial (RA) pressures were greater than 18 mmHg and pulmonary occlusion pressures (POC) were ≤ 3 mmHg of the RA pressure. Results: Of the study cohort, 53/529 patients had RA pressures ≥18 mmHg. The average age of this group was 63 ± 13 yrs. The mean RA and POC were 22 ± 5 mmHg and 29 ± 6 mmHg, respectively. The hemodynamic and echo data of patients with suspected VI (+) (n = 34) versus those without (VI-, n = 19) are shown in the Table. VI is relatively common (64%) when RA pressures are ≥ 18 mmHg. Only 2/476 patients in the group where the RA <18 mmHg showed right / left pressure equilibration. VI appears less likely in the setting of predominant left-sided chamber dilation and hypokinesis. The prevalence of RV dilation / hypokinesis, MR and TR were similar in the VI+ and VI- groups. Conclusions: VI should be considered to affect hemodynamics in substantial proportion of heart failure patients with RA ≥ 18 mmHg, and seems more likely to be evident when LV function is relatively preserved. Tabled 1Hemodynamic and Echo data VI+ (n = 34) VI− (n = 19) Age 62 ± 15 64 ± 14 RA (mean mmHg) 24 ± 6 20 ± 2 PA systolic (mmHg) 59 ± 14 59 ± 13 PA diastolic (mmHg) 28 ± 7 28 ± 6 POC (mean, mmHg) 25 ± 6 32 ± 5 RV dilation / HK (n,%) 6 (18%) 6 (33%) LV dilation / HK (n,%) 11 (32%) 11 (58%) # P < 0.05. ≥ Moderate MR 7 (21%) 4 (21%) ≥ Moderate TR 11 (32%) 6 (31%) HK, hypokinesis; MR and TR, mitral and tricuspid regurgitation. # P < 0.05. Open table in a new tab HK, hypokinesis; MR and TR, mitral and tricuspid regurgitation." @default.
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• W2081185698 date "2006-08-01" @default.
• W2081185698 modified "2023-09-25" @default.
• W2081185698 title "Ventricular Interdependence Heart Failure Patients: Prevalence and Predisposing Conditions" @default.
• W2081185698 doi "https://doi.org/10.1016/j.cardfail.2006.06.463" @default.
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