Clinical study
Performance of the failing and nonfailing right ventricle of patients with pulmonary hypertension

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Abstract

Hemodynamic performance of the right ventricle was measured in 34 patients: 17 with pulmonary hypertension, 9 with pulmonary hypertension and right ventricular failure and 8 control subjects. Among the patients with pulmonary hypertension who did not have right ventricular failure, right ventricular maximal isovolumic rate of development of ventricular pressure (dPdt) was significantly elevated (P < 0.001), whereas maximal 1PdPdt and maximal velocity of contractile element shortening (Vmax) were comparable with values observed in control subjects. The patients with pulmonary hypertension who had right ventricular failure also showed an augmented right ventricular maximal dPdt (P < 0.001) and normal 1PdPdt and Vmax. These observations indicate that in pulmonary hypertensive heart disease, even when the right ventricle failed in a clinical sense, the contractile effort was normal. Consequently, right ventricular failure may develop in patients with pulmonary hypertensive heart disease even though the cardiac muscle performs normally as a contractile tissue.

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    This study was supported by project R38820 from funds supplied by Henry Ford Hospital through a grant from the Ford Foundation, New York, New York, and by Grant HL 23669-01 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.

    Visiting Investigator. Present address: Fisiologia Clinica CNR, Via Savi 8, 56100 Pisa, Italy.

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