Abstract
Left ventricular (LV) contraction contributes importantly to right ventricular (RV) performance via left to right ventricular interaction (LV-RVI). To determine the magnitude of LV-RVI in human heart failure, 5 explanted hearts with dilated cardiomyopathy (DCM) were obtained at the time of transplant and restored to a beating condition using a blood perfusion system. One normal human heart, unsuitable for transplantation, was also obtained and served as control. Balloons were placed in both RV and LV With RV volume fixed at an end diastolic pressure (EDP) of 20 mmHg, LV volume was ramped from low (LV EDP = 0) to high (LV EDP = 30) and resulting changes in RV systolic pressures were plotted vs. changes in LV pressure. The slope of this line defines the LV-RVI pressure gain. An analogous procedure was used to determine RV-LVI. The figures depict representative data. In the DCM hearts mean ( ± SD) LV-RVI gain was 0.26 ± 0.06 and RV-LVI was 0.16 ± 0.12. In the control heart LV-RVI = 0.08 and RV-LVI = 0.15. LV-RVI is markedly increased in heart failure when compared to the control. This is consistent with previous reports using animal models. Conversely, RV-LVI remains unaffected by heart failure. These data, not previously available from humans, suggest that LV contribution to RV performance is significantly enhanced in chronic heart failure.
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