Haemodynamic findings in experimental right ventricular ischaemia after right coronary arterial ligation
1986; Oxford University Press; Volume: 7; Issue: 8 Linguagem: Inglês
10.1093/oxfordjournals.eurheartj.a062127
ISSN1522-9645
AutoresIsabel Coma-Canella, J. LOPEZ-SENDON, F Lombera, J. Silvestre, Miguel Ángel García Fernández,
Tópico(s)Coronary Artery Anomalies
ResumoAcute ischaemia limited to the free wall of the right ventricle was produced by right coronary arterial ligation (RCAL) in 20 dogs. Contrast M-mode and cross-sectional echocardiography was performed in 7 cases to investigate the presence of tricuspid insufficiency. The haemodynamic findings obtained with an open pericardium at 15 to 30 min showed increases in right (l.2∓0.5 to 2.7∓0.7 mmHg, P∼0.01) andleft (5.0 ∼ 0.8 to 6.6∓0.9 mmHg, P∓005) ventricular end-diastolic pressures, and decreases in heart rate (139∓4.9 to 119∓5.1 bpm, P∼0.01), cardiac index (106∓6.6 to 81∓7.3 ml min−1 kg−1, P∼001), stroke index (79 ∓6 to 72 ∓8 ml × 100 beat−1 kg−1, P∼0.02), right (23.8∓l.5 to 19.4∓1.5 mmHg, P∼0.01) and left (109∓7.2 to 95∓8.2 mmHg, P∼005) ventricular systolic pressures and right ventricular stroke work index (18.3∓2.4 to 11.4∓1.8 g m kg−1, P∼0.01). In 6 of 15 cases the 'y' descent became deeper than the 'x' descent in right atrial pressure (RAP). Tricuspid insufficiency grade I–II/IV was present in 3 of 7 cases, 2 of them with a 'y'>'x' in RAP. Right ventricular mechanical alternans, probably secondary to a decrease in contractility, appeared in 10 of 20 cases after RCAL. Closure of the pericardium exaggerated the haemodynamic alterations and a dip-plateau appeared in 2 cases on the right ventricular pressure curve. We conclude that significant aemodynamic alterations in right ventricular function are produced by RCAL in dogs, and they are exaggerated after closing the pericardium.
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