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PubMed1983

Left ventricular function in preeclamptic patients: an echocardiographic study.

To examine left ventricular function in pregnancy complicated by preeclampsia, echocardiographic dimensions and left ventricular performance indices were determined in 42 preeclamptic patients, 25 normotensive third-trimester patients, and 25 nonpregnant patients. The performance of the left ventricle in normal third-trimester pregnant patients was unchanged as compared to that in nonpregnant patients. Three patients (7%) in the preeclamptic group had diminished values of echocardiographic contractility indices. However, in only one of these patients were there clinical signs of left heart failure; two other patients had latent myocardial dysfunction. Our conclusion is that left ventricular function in most preeclamptic patients is well preserved despite significant volume and pressure overload.

Blood Pressure↗

PubMed1985

[Left ventricular function in essential hypertension during isoproterenol infusion].

The left ventricular function of 23 patients with essential hypertension was investigated during infusion of isoproterenol (ISP). These patients consisted of 13 without cardiac hypertrophy (Group NH) and 10 with cardiac hypertrophy (Group HH). Ten normotensive subjects served as normal controls. To assess left ventricular functions, M-mode echocardiograms were recorded at rest and after ISP infusion for 5 minutes (0.005 and 0.01 microgram/kg/min). There were no significant differences in peak negative dD/dt in all groups at rest. But peak negative dD/dt of Group HH significantly decreased after an infusion of 0.005 microgram/kg/min ISP (Group N: 3.43 +/- 0.69, Group NH: 3.15 +/- 0.61, and Group HH: 2.49 +/- 0.48 cm/sec, respectively). The peak negative dD/dt of Group HH was also significantly decreased after a dose of 0.01 microgram/kg/min. Among all patients with hypertension, peak negative dD/dt correlated inversely with left ventricular mass (LVM) after the infusion of ISP (0.005 microgram/kg/min: r = -0.64, p less than 0.001, 0.01 microgram/kg/min: r = -0.68, p less than 0.001). The peak positive dD/dt of Group HH was significantly decreased only when compared with that of Group N at rest (Group N: 3.15 +/- 0.75, Group NH: 3.02 +/- 0.86, and Group HH: 1.92 +/- 0.68 cm/sec, respectively). The difference between the peak positive dD/dt of Group HH and that of Group N was more prominent after the infusion of ISP than at rest. Among all patients with hypertension, the peak positive dD/dt was inversely related to LVM at rest (r = -0.64, p less than 0.002). There was a similar relation between the two indexes after the infusion of ISP. Peak positive dD/dt was related to peak negative dD/dt after a dose of 0.01 microgram/kg/min in Group HH (r = 0.67, p less than 0.05). There was no significant difference in heart rate, change in blood pressure, or total peripheral vascular resistance after the infusion of ISP. It is concluded that diastolic left ventricular dysfunction and latent systolic left ventricular dysfunction are related to increased LVM in Group HH. It seems that after the infusion of ISP severe diastolic left ventricular dysfunction is related to latent systolic left ventricular dysfunction.

Adult↗

PubMed1990

[The role of isotope methods in evaluating the left ventricular function].

Cardiac angioscintigraphy is a non-invasive, reproducible and reliable technique used to obtain a number of cardiac function parameters, the most important of which is left ventricular ejection fraction. Methodologically, the examination is simple. Fourier's analysis (a mathematical decomposition of ventricular mechanics) provides additional information on some abnormalities and is particularly useful in segmental kinetics studies and in the topographical diagnosis of cardiac rhythm disorders. The technique is indicated mainly for prognostic evaluation and follow-up of patients with left ventricular dysfunction. Metaiodobenzylguanidine (MIBG) cardiac scintigraphy makes it possible to evaluate the reuptake of noradrenaline by neurons, which represents the inactivation pathway of adrenergic neurotransmission and is the principal factor of noradrenaline extraction. MIBG scintigraphy is an indirect way of evaluating left ventricular function in congestive heart failure, as suggested by the results of studies showing correlations between MIBG uptake, left ventricular function indices and disease severity as judged on the basis of evolutive parameters.

3-Iodobenzylguanidine↗

PubMedDate not supplied

Comparison of left ventricular function at rest and post-stress in patients with myocardial infarction: Evaluation with gated SPECT.

BACKGROUND: Quantitative electrocardiogram-gated single photon emission computed tomography (SPECT) myocardial imaging (QGS) is a means of providing functional information about the left ventricle and myocardial perfusion. However, the functional information derived 30 minutes post-stress may be different from the left ventricular (LV) function determined at rest. This study determined whether LV function post-stress would be different from LV function at rest in patients with an earlier myocardial infarction. METHODS AND RESULTS: LV perfusion and ejection fraction (LVEF), were determined by means of both the rest and post-stress acquisition in 58 patients with an earlier myocardial infarction and in 23 patients with a low likelihood of coronary artery disease by using technetium-99m tetrofosmin and the QGS program. The interobserver and intraobserver variability of LVEF was excellent, within a margin of 2%. No significant differences in LVEF were observed between post-stress and rest in the 23 patients with a low likelihood of disease (DeltaLVEF, 0.04% +/- 3.2%, P = not significant). Conversely, the patients with an earlier myocardial infarction showed a significantly lower LVEF post-stress, compared with that at rest (DeltaLVEF, -1.9% +/- 4.2%, P =.002). In 33 patients (57%), the LVEF post-stress was 2% or more lower than the LVEF at rest. Furthermore, reversible ischemia, which was present in 16 patients (28%), did not interact with the DeltaLVEF post-stress, compared with the DeltaLVEF at rest (P = not significant). Parameters such as the stress modality (adenosine stress or exercise), the number of stenosed vessels, or the perfusion defect severity score did not influence the DeltaLVEF post-stress, compared with the DeltaLVEF at rest. CONCLUSIONS: In patients with an earlier myocardial infarction, LV function post-stress may not represent the true resting LV function. Consequently, this result justifies the stratification of patients before starting the gated SPECT study. In patients with an earlier myocardial infarction, the gated acquisition should be performed during the rest study.

Adenosine↗

PubMed2000

A narrow QRS does not predict a normal left ventricular function in Chagas' disease.

Left ventricular (LV) systolic dysfunction is a major prognostic determinant in Chagas' disease (ChD), a potentially fatal disorder which affects nearly 20 million individuals in Latin America. Therefore, reliable screening methods are needed to identify patients in need of a detailed evaluation of LV function. Since previous reports have suggested that a prolonged QRS duration may be an accurate predictor of LV dysfunction, the relationship between QRS duration and LV function was evaluated in ChD patients, in order to determine whether a narrow QRS on surface electrocardiogram (ECG) predicts a normal LV function. Ninety-eight patients with ChD and no other cardiac or systemic illness were underwent standard 12-lead ECG and Doppler echocardiogram (echo) examination. An investigator (blinded to the echo data) measured manually the QRS duration. LV dysfunction was defined by the presence of LV dilatation (LV diastolic dimension > 55 mm), depressed LV ejection fraction (LVEF < 0.50), segmental contractile abnormalities (SCA) or LV aneurysm. QRS duration was significantly correlated with LV diastolic dimension (r = 0.44, P = 0.000) and LVEF (r = 0.24, P = 0.016). A significant percentage of patients with QRS < 100 ms had abnormal systolic LV parameters, including LV dilatation (8.1%), reduced EF (10.2%), SCA (42.8%) and LV aneurysm (14.2%). A narrow QRS does not exclude the presence of significant global and segmental LV dysfunction in ChD patients. Since these abnormalities have prognostic and therapeutic implications, further evaluation of LV systolic performance is desirable in such patients.

Adult↗

PubMed2006

Performance of two-dimensional Doppler echocardiography for the assessment of infarct size and left ventricular function in rats.

Although echocardiography has been used in rats, few studies have determined its efficacy for estimating myocardial infarct size. Our objective was to estimate the myocardial infarct size, and to evaluate anatomic and functional variables of the left ventricle. Myocardial infarction was produced in 43 female Wistar rats by ligature of the left coronary artery. Echocardiography was performed 5 weeks later to measure left ventricular diameter and transverse area (mean of 3 transverse planes), infarct size (percentage of the arc with infarct on 3 transverse planes), systolic function by the change in fractional area, and diastolic function by mitral inflow parameters. The histologic measurement of myocardial infarction size was similar to the echocardiographic method. Myocardial infarct size ranged from 4.8 to 66.6% when determined by histology and from 5 to 69.8% when determined by echocardiography, with good correlation (r = 0.88; P < 0.05; Pearson correlation coefficient). Left ventricular diameter and mean diastolic transverse area correlated with myocardial infarct size by histology (r = 0.57 and r = 0.78; P < 0.0005). The fractional area change ranged from 28.5 +/- 5.6 (large-size myocardial infarction) to 53.1 +/- 1.5% (control) and correlated with myocardial infarct size by echocardiography (r = -0.87; P < 0.00001) and histology (r = -0.78; P < 00001). The E/A wave ratio of mitral inflow velocity for animals with large-size myocardial infarction (5.6 +/- 2.7) was significantly higher than for all others (control: 1.9 +/- 0.1; small-size myocardial infarction: 1.9 +/- 0.4; moderate-size myocardial infarction: 2.8 +/- 2.3). There was good agreement between echocardiographic and histologic estimates of myocardial infarct size in rats.

Animals↗

PubMed1995

Echocardiographic assessment of systolic and diastolic left ventricular function using an automatic boundary detection system. Correlation with established invasive and non invasive parameters.

Systolic and diastolic left ventricular function was assessed using an echocardiographic automatic boundary detection system (ABD) in 50 unselected patients undergoing left cardiac catheterisation. Automatic boundary detection system derived parameters (fractional area change [FAC], peak positive rate of area change [+dA/dt] and peak negative rate of area change [-dA/dt]) were compared with invasively (left ventricular angiography and pressures) and non invasively (Doppler mitral filling velocities and isovolumic relaxation time) acquired conventional indices of ventricular function. Adequate detection of endocardial boundaries and subsequent measurements using the ABD system were achieved in 40/50 (80%) patients in the short axis parasternal view, in 41/50 (82%) in the apical four chamber view and in 34/50 (68%) in both views. For the whole group of patients the FAC (maximal left ventricular diastolic area--minimal left ventricular systolic area/maximal left ventricular diastolic area) estimated in the short axis view correlated with the angiographic ejection fraction (EF) measured in the right oblique projection (r = 0.51, p < 0.001). There was only a weak correlation of the FAC estimated in the apical four chamber view with the EF (r = 0.36, p < 0.01). The mean FAC (mean value of the FAC in the short axis and apical four chamber views) correlated reasonably with the EF (r = 0.62, p < 0.0001). There was no correlation between ABD derived parameters and left ventricular end diastolic pressure (LVEDP) in these patients. In a subgroup of patients with normal coronary arteries and left ventricular function (n = 17), although there was no correlation between EF and FAC, there was a strong positive correlation between FAC (apical four chamber and mean) and LVEDP (r = 0.77, p < 0.01 and r = 0.87, p < 0.01 respectively). No correlation was found in these patients between EF and LVEDP. In a further subgroup of patients with angiographically abnormal left ventricular function (EF < 45%), there was a positive correlation between FAC (short axis, apical four chamber and mean) and EF (r = 0.52, p < 0.05, r = 0.83, p < 0.0001 and r = 0.80, p < 0.001 respectively) and a negative correlation between FAC (short axis and mean) and LVEDP (r = -0.52, p < 0.05 and r = -0.60, p < 0.01 respectively). There was also a negative correlation between LVEDP and EF in the same subgroup of patients (r = -0.65, p < 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed2000

Magnetic resonance imaging assessment of left ventricular function and wall motion.

Assessment of left ventricular (LV) function is essential for the diagnosis and treatment of cardiac patients. A reliable and noninvasive tool for quantifying global and local LV function is needed. Magnetic resonance (MR) imaging has several unique features that are well suited to clinical examinations: it is noninvasive, does not expose the patient to ionizing radiation, and provides images of high spatial resolution and excellent soft tissue contrast without the need for contrast medium injection. In this paper, I review the reported evidence concerning the validity of MR imaging assessment of LV volume, including end-diastolic volume, end-systolic volume, and ejection fraction, and the validity of using MR imaging to monitor LV wall motion. Abundant evidence from phantom, animal, and human studies supports that MR imaging provides accurate and reproducible information that is substantially superior to that from conventional modalities such as angiographic ventriculography, radionuclide scintigraphy, and echocardiography. A fast MR imaging technique, cine MR imaging, further enhances the clinical feasibility of MR imaging by reducing the scanning time to about 20 minutes. Today, cine MR imaging is widely accepted as a reliable clinical tool. It may be considered an in vivo standard for quantification of LV volume and wall motion. Faster MR imaging techniques, such as TurboFLASH and echo-planar imaging, decrease the examination time to several seconds. This allows evaluation of transient functional changes during pharmacologically or physically induced stress tests.

Humans↗

PubMed2003

Myocardial contrast echocardiography for the assessment of left ventricular function.

Assessment of regional and global left ventricular (LV) function is important in the management of patients with known or suspected cardiovascular disease. Echocardiography is widely used to provide vital parameters of LV function such as ejection fraction, wall motion score indices, LV volumes and regional wall motion assessment. Despite advances in image quality some images may still be inadequate for accurate assessment of LV function. The advent of intravenous contrast agents consisting of microbubbles have allowed improved endocardial definition leading to better assessment of global and regional function. This together with advances in low power imaging techniques allow less microbubble destruction and hence smaller doses of contrast agent. Improved endocardial definition has also lead to advances in techniques for the automated quantification of LV function. As a result contrast enhanced echocardiography may become the gold-standard in the assessment of wall motion and LV function.

Contrast Media↗

PubMedDate not supplied

Doppler ultrasound in assessing systolic left ventricular function in cardiovascular patients.

Determination of left ventricular (LV) function is of vital importance in cardiovascular medicine and surgery. Various methods have been introduced to achieve this goal but a noninvasive method is more appropriate as it could be used during exercise to follow-up patients and study the response to medical or surgical intervention. The Doppler ultrasound technique of transcutaneous aortovelography (TAV) has been introduced as a successful approach using a 2 MHz transducer to measure the aortic blood velocity in the aortic arch. From the Doppler ultrasound signals the systolic velocity integral is derived (Sd; the stroke distance which is an index of stroke volume) and its percentage change at maximal-tolerated supine exercise (% delta Sd). The latter was found to be a function of LV ejection fraction and thus proved to be a useful approach to assess LV function in patients with coronary artery disease. Using TAV it was found that coronary artery bypass grafting improves LV function during exercise (rather than at rest) irrespective of the presence of a history of myocardial infarction prior to the operation. In patients with intermittent claudication assessment of LV function proved of great use. The % delta Sd was significantly lower in claudicants with positive stress ECG tests than those with negative test. There was a linear correlation (r = 0.51) between the % delta Sd and the percentage change in the ankle/brachial systolic blood pressure index in response to standard 1 minute of exercise. Assessment of LV function in cardiovascular patients is thus of great clinical importance and provides more insight into the mechanism of the disease and assess the response to management.

Cardiovascular Diseases↗

PubMed1989

[The effect of a combination of ridazolol and molsidomine on hemodynamics and left ventricular function in dilated cardiomyopathy].

Haemodynamics and Left Ventricular Function in Patients with Dilated Cardiomyopathy after a Combination of Ridazolol and Molsidomine. To evaluate the haemodynamic properties of the new beta-blocker ridazolol alone and in combination with the vasodilator molsidomine a randomized study was carried out in 12 patients with dilated cardiomyopathy (NYHA II/III). beta-Blockade leads to a decreasing tendency in blood pressure and heart rate. Pulmonary capillary wedge pressure (PC) was not significantly altered and ejection fraction remained unchanged. Molsidomine showed a decrease of PC. The combination of both drugs revealed both the positive haemodynamic effects of molsidomine and the reduced heart rate of beta-blockade. Negative side effects could not be observed.

Adrenergic beta-Antagonists↗

PubMed1986

Early improvement of left ventricular function during caloric restriction in obesity.

Left ventricular function (LVF) was studied in 25 obese patients (four males and 21 females) by serial poligraphic measurements, namely systolic time intervals (STI), during a short period of dieting (2721 kJ/day (650 kcal/day) as single daily meal regimen). In the same period, all the patients underwent also three standardized exercise tests at the cycloergometer. At the end of the study (20th day), statistically significant differences were obtained in weight loss (P less than 0.001); two main parameters of STI, namely pre-ejection period index (PEPI) and PEP/LVET ratio were lowered (P less than 0.001): furthermore, peak and recovery systolic blood pressure (SBP) and heart rate (HR) during exercising, were also significantly reduced. These data suggest that an improvement of LVF and cardiac performance are present since the early phases of caloric restriction in obesity.

Adolescent↗

PubMed1976

Diabetes mellitus and left ventricular function.

Chronic diabetes mellitus can alter left ventricular function independent of vascular effects. On the basis of available morphologic data in human and canine diabetics, alterations of myocardial interstitium may be the basis for this preclinical abnormality. The abnormal function is independent of apparent duration and treatment by diet, insulin, or hypoglycemic agents. It occurs in both sexes and is independent of age. Whether the observed functional abnormality progresses to clinical heart failure may depend on intensification of the underlying pathophysiology of the myocardium or superimposition of complications such as hypertension, obesity, and obstructive disease of the coronary vessels.

Animals↗

PubMed2000

Positron emission tomography and low-dose dobutamine echocardiography in the prediction of postrevascularization improvement in left ventricular function and exercise parameters.

BACKGROUND: We studied the value of low-dose dobutamine echocardiography (LDDE) and positron emission tomography (PET) in predicting improvement of left ventricular function and exercise parameters after revascularization. METHODS: Forty-six consecutive patients with ischemic heart disease and an ejection fraction (EF) of 35% +/- 7% were included. Before revascularization, the patients underwent exercise testing and myocardial viability testing by LDDE and fluoride 18-fluoro-2-deoxyglucose PET. Six months after revascularization they underwent coronary angiography to study graft patency, and echocardiographic examination and the exercise test were repeated. RESULTS: In the prediction of the presence or absence of improved postrevascularization function in left ventricular regions with patent grafts, PET was more sensitive than LDDE (42/52 regions [81%] vs 27/52 regions [51%], P <.01), whereas LDDE was more specific than PET (187/209 regions [89%] vs 118/209 regions [56%], P <.001). Improvement of regional myocardial dysfunction was found in 19 patients, but their global left ventricular function did not improve significantly (EF 34% +/- 6% and 36% +/- 7%). In the remaining 27 patients with irreversible dysfunction, EF decreased (EF 36% +/- 7% vs 32% +/- 8%, P <.05). Among patients with reversible myocardial dysfunction, the rate pressure product (RPP) increased after revascularization (19,522 +/- 5474 vs 26,190 +/- 5610 mm Hg/min, P <.01), whereas the RPP did not change in patients with irreversible myocardial dysfunction (21,546 +/- 5450 and 22,774 +/- 8249 mm Hg/min). The number of PET viable segments was a predictor of the postoperative increase in the RPP in univariate (P <.04) and multivariate analyses (P <.001). In contrast, LDDE did not bear any prognostic information about improvement in the RPP. CONCLUSIONS: This study confirms earlier findings of higher sensitivity and lower specificity of PET compared with LDDE in predicting improvement of regional left ventricular function after revascularization. However, the feasibility of predicting postrevascularization improvement of exercise parameters seems unique for PET. The potential prognostic value of this finding needs further investigation.

Cardiotonic Agents↗

PubMed1979

Right and left ventricular function after the Mustard procedure in transposition of the great arteries.

Right and left ventricular function was assessed at cardiac catheterization in 33 asymptomatic patients 0.5 to 11 years (mean 4.6) after the Mustard operation for complete transposition of the great arteries. Ages at operation had ranged from 0.5 to 16 years (mean 4.2 years). Right ventricular function was assessed using videodensitometric determination of ejection fraction and ventricular volume data. Ventricular volumes were obtained by computerized video analysis utilizing Simpson's rule. The right ventricular ejection fraction was 37 +/- 11 percent (standard deviation), as assessed with videodensitometry and 42 +/- 10 percent as assessed with ventricular volume--both values less than normal (P less than 0.001). Right ventricular end-diastolic volume was significantly greater than normal (P less than 0.001) and averaged 202 +/- 70 percent, but left ventricular end-diastolic volume averaged only 125 +/- 53 percent. These observations after the Mustard operation indicate that right ventricular function is seriously decreased with relatively preserved left ventricular function. They support efforts for surgical correction utilizing the left ventricle as the systemic ventricle.

Age Factors↗

PubMed2002

[Are there effects due to the existence of coronary collateral circulation on left ventricular function in patients with coronary artery disease?].

OBJECTIVE: The role of coronary collateral circulation (CCC) on the improvement of left ventricular function in coronary artery disease is controversial. The aim of this study is to investigate the effect of CCC on left ventricular function in patients with ischaemic heart disease. METHODS: Accordingly, 76 patients (39 female, 37 male, mean age--61 +/- 17 years) who had single vessel disease with > 85% narrowing in left anterior descending coronary artery were enrolled in this study. Coronary collateral circulation was determined according to the Rentrop classification (Class 0 = no collateral circulation; class 1 = small branches of occluded vessel fill with CCC; class 2 = epicardial segment of the occluded vessel partially fills with CCC; class 3 = epicardial segment of the occluded vessel totally fills with CCC). Left ventricular function was assessed with echocardiography and left ventricular regional wall motion score (0 = normokinetic; 1 = hypokinetic; 2 = akinetic; 3 = dyskinetic; 4 = aneurysmatic). Rentrop classification of the patients were compared with left ventricular regional wall motion scores and ejection fractions. RESULTS: Twenty one of 76 patients had no collateral circulation. The regional wall motion score of class 0 patients was similar with that of patients with CCC (class 1,2,3) (2.28 +/- 2.1 vs 3.39 +/- 2.1, p > 0.05). Particularly, the regional wall motion score was positively correlated with Rentrop classes (p < 0.05). Class 3 patients had the highest wall motion score (4.24 +/- 2.5, p < 0.05). Patients with and without CCC had similar left ventricular ejection fractions (49 +/- 11 vs 46 +/- 17, p > 0.05). CONCLUSION: This study showed that development of CCC has no preventive effect on left ventricular functions in patients with coronary artery disease. Interestingly as the stage of CCC increases left ventricular function worsens. It may be the result of the fact that patients with well developed CCC have more severe coronary artery disease.

Collateral Circulation↗

PubMed2003

Effect of recanalization of chronic total occlusions on global and regional left ventricular function in patients with or without previous myocardial infarction.

Previous studies have demonstrated improvement of regional wall motion and global left ventricular function after successful recanalization of chronic total occlusion in coronary artery. However, the difference of benefits of recanalization between infarct site and noninfarct site is unknown. This study assessed the changes in left ventricular ejection fraction, regional wall motion after successful angioplasty of chronic total occlusions with or without previous myocardial infarction. This study also evaluated the factors that influenced the outcome of left ventricular function. We retrospectively studied 75 patients with a successfully recanalized chronic total occlusion in native coronary artery. Left ventriculograms were obtained at baseline and after 6 months. Global and regional left ventricular function were determined. The patients were divided into two groups. Group 1 comprised patients without previous myocardial infarction in the territories of total occlusion vessel that was recanalized. Group 2 comprised patients with previous myocardial infarction in the territories of total occlusion vessel that was recanalized. Left ventricular ejection fraction increased from 53.2% +/- 16.3% at baseline to 57.3% +/- 20.1% at 6-month follow-up in the whole group (P = 0.001). In group 1 patients, the evolution of left ventricular (LV) ejection fraction increased from 59.5% +/- 13.7% to 67.3% +/- 14.6% (P < 0.001). In group 2 patients, the evolution of LV ejection fraction increased, but not significantly, from 48.9% +/- 16.2% to 50.5% +/- 16.9% (P = NS). The evolution of LV ejection fraction increased from 47.6% +/- 17.4% to 50.8% +/- 17.5% (P < 0.05) in the subgroup of recanalization in infarct-related vessel that had rich collateral circulation and had long-term patency. The regional wall motion all significantly improved in group 1 patients (P < 0.05). The regional wall motion did not change in group 2 patients (P = NS). The influence of recanalization of chronic coronary occlusions on the improvement of left ventricular global function was different between myocardial infarction and nonmyocardial infarction patients. The left ventricular function did not improve in myocardial infarction patient. Regional wall motion improved in patients without previous myocardial infarction. For reliable improvement of left ventricular function after recanalization of chronic total occlusions, evidence (not only by symptom or treadmill test) of viable myocardium in recanalized vessel is important. It is also important to keep patency of infarct-related vessel that has good collateral circulation for improving the left ventricular function.

Aged↗

PubMed1998

[Left ventricular function in pulmonary arterial hypertension].

Echocardiographic evaluation was done of left ventricular functional state in 90 patients with primary and secondary pulmonary arterial hypertension with and without intercavitary shunting. Changes in left ventricular function were identified in 86% cases; they reflected disturbances in both ventricles compensatory interaction. The degree of changes depended on the degree of dilatation of the right ventricle and level of interchamber shunting.

Adolescent↗