Wei-Tsung Lai1, Ho-Ping Yu1, Chang-Chyi Lin1,2, Wei-Hsian Yin1, Tsung-Yu Ko3,4, Juey-Jen Hwang5, Lung-Chun Lin5, Kuan-Chih Huang1,3. 1. Heart Center, Cheng-Hsin General Hospital. 2. Cardiology, Department of Internal Medicine, National Defense Medical Center. 3. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei. 4. National Taiwan University Hospital Hsin-Chu Biomedical Park Branch, Hsinchu. 5. Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: A well-functioning cardiopulmonary system, which works as a pump, should generate adequate stroke volume with as little stroke work as possible. We propose a new composite parameter, right ventricular (RV) pump efficiency (η) = left ventricular stroke volume / right ventricular stroke work, to describe this idea in a volume overload population with secundum-type atrial septal defect (ASD). METHODS: We consecutively enrolled 50 patients with secundum-type ASD to investigate the relationship between right-sided volume overload and RV pump efficiency. Sixteen patients with a pulmonary to systemic flow ratio (Qp/Qs) > 1.5 underwent implantation of an occluder. The paired t test was used to compare RV pump efficiency before and after ASD closure. RESULTS: RV pump efficiency was inversely correlated with Qp/Qs and was 60 ± 20‰ · mmHg-1 at Qp/Qs = 1. After ASD closure, RV volume, ejection fraction and free wall strain all significantly decreased, while RV pump efficiency significantly increased from 27.4 ± 13.6 to 63.9 ± 20.4‰ · mmHg-1. CONCLUSIONS: RV pump efficiency can superiorly reflect the chronicity and severity of secundum-type ASD.
BACKGROUND: A well-functioning cardiopulmonary system, which works as a pump, should generate adequate stroke volume with as little stroke work as possible. We propose a new composite parameter, right ventricular (RV) pump efficiency (η) = left ventricular stroke volume / right ventricular stroke work, to describe this idea in a volume overload population with secundum-type atrial septal defect (ASD). METHODS: We consecutively enrolled 50 patients with secundum-type ASD to investigate the relationship between right-sided volume overload and RV pump efficiency. Sixteen patients with a pulmonary to systemic flow ratio (Qp/Qs) > 1.5 underwent implantation of an occluder. The paired t test was used to compare RV pump efficiency before and after ASD closure. RESULTS: RV pump efficiency was inversely correlated with Qp/Qs and was 60 ± 20‰ · mmHg-1 at Qp/Qs = 1. After ASD closure, RV volume, ejection fraction and free wall strain all significantly decreased, while RV pump efficiency significantly increased from 27.4 ± 13.6 to 63.9 ± 20.4‰ · mmHg-1. CONCLUSIONS: RV pump efficiency can superiorly reflect the chronicity and severity of secundum-type ASD.
Entities:
Keywords:
Right ventricular pump efficiency; Three-dimensional echocardiography; Volumetric analysis
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