STUDY OBJECTIVE: The development of right ventricular (RV) hypertrophy in emphysema is accompanied by involvement of the left ventricle (LV) and its systolic function. Our objective was to study the relation between RV hypertrophy and LV ejection fraction in emphysema by means of MRI. PATIENTS: Ten emphysematous patients (FEV1, 0.99+/-0.32 L; FEV1/vital capacity (VC), 0.32+/-0.11 [mean+/-SD]) and 10 age-matched control subjects were included. Exclusion criteria were any history of systemic hypertension, ischemic or valvular heart disease, or episodes of right- and/or left-sided cardiac failure. MEASUREMENTS AND RESULTS: Rapid scout imaging was used to measure RV and LV wall mass, wall thickness, and end-diastolic volume. Stroke volume was derived from the main pulmonary artery flow. RV wall volume, RV wall thickness, and the ratio of RV to LV wall thickness were significantly larger in the patient group than in the control group (p<0.01). Furthermore, patients had significantly lower values of LV ejection fraction (p<0.01) than the control subjects. A flattening or leftward displacement of the ventricular septum during systole was observed. In addition, our study showed an increase of LV ejection fraction proportional with the RV wall thickness (r=0.78, p<0.01) in severely emphysematous patients. CONCLUSION: These data are in support of the hypothesis that flattening of the interventricular septum explains the relatively normal LV ejection fraction in emphysematous patients with severe RV hypertrophy.
STUDY OBJECTIVE: The development of right ventricular (RV) hypertrophy in emphysema is accompanied by involvement of the left ventricle (LV) and its systolic function. Our objective was to study the relation between RV hypertrophy and LV ejection fraction in emphysema by means of MRI. PATIENTS: Ten emphysematouspatients (FEV1, 0.99+/-0.32 L; FEV1/vital capacity (VC), 0.32+/-0.11 [mean+/-SD]) and 10 age-matched control subjects were included. Exclusion criteria were any history of systemic hypertension, ischemic or valvular heart disease, or episodes of right- and/or left-sided cardiac failure. MEASUREMENTS AND RESULTS: Rapid scout imaging was used to measure RV and LV wall mass, wall thickness, and end-diastolic volume. Stroke volume was derived from the main pulmonary artery flow. RV wall volume, RV wall thickness, and the ratio of RV to LV wall thickness were significantly larger in the patient group than in the control group (p<0.01). Furthermore, patients had significantly lower values of LV ejection fraction (p<0.01) than the control subjects. A flattening or leftward displacement of the ventricular septum during systole was observed. In addition, our study showed an increase of LV ejection fraction proportional with the RV wall thickness (r=0.78, p<0.01) in severely emphysematouspatients. CONCLUSION: These data are in support of the hypothesis that flattening of the interventricular septum explains the relatively normal LV ejection fraction in emphysematouspatients with severe RV hypertrophy.
Authors: Sunil K Agarwal; Gerardo Heiss; R Graham Barr; Patricia P Chang; Laura R Loehr; Lloyd E Chambless; Eyal Shahar; Dalane W Kitzman; Wayne D Rosamond Journal: Eur J Heart Fail Date: 2012-02-25 Impact factor: 15.534
Authors: Antonio Di Petta; Rafael Simas; Clebson L Ferreira; Vera L Capelozzi; Vera M C Salemi; Luiz F P Moreira; Paulina Sannomiya Journal: Int J Exp Pathol Date: 2015-10-29 Impact factor: 1.925
Authors: J Michael Wells; Anand S Iyer; Farbod N Rahaghi; Surya P Bhatt; Himanshu Gupta; Thomas S Denney; Steven G Lloyd; Louis J Dell'Italia; Hrudaya Nath; Raul San Jose Estepar; George R Washko; Mark T Dransfield Journal: Circ Cardiovasc Imaging Date: 2015-04 Impact factor: 7.792
Authors: R Graham Barr; David A Bluemke; Firas S Ahmed; J Jeffery Carr; Paul L Enright; Eric A Hoffman; Rui Jiang; Steven M Kawut; Richard A Kronmal; João A C Lima; Eyal Shahar; Lewis J Smith; Karol E Watson Journal: N Engl J Med Date: 2010-01-21 Impact factor: 91.245