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Interventricular Mechanical Asynchrony Due To Right Ventricular Pressure Overload in Pulmonary Hypertension Plays an Important Role in Impaired Left Ventricular Filling*

Anton Vonk-Noordegraaf, MD, FCCP; Johan T. Marcus, JT PhD; C. Tji Gan, MSc; Anco Boonstra, MD; Pieter E. Postmus, MD, FCCP
Author and Funding Information

*From the Departments of Pulmonary Medicine (Vonk-Nordegraaf and Boonstra, and Mr. Gan), and Physics and Medical Technology (Dr. Marcus), Institute for Cardiovascular Research, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands.

Correspondence to: A. Vonk-Noordegraaf, MD, FCCP, University Hospital Vrije Universiteit, Department of Pulmonary Medicine, PO Box 7057, 1007 MB Amsterdam, The Netherlands; e-mail: A.Vonk@vumc.nl



Chest. 2005;128(6_suppl):628S-630S. doi:10.1378/chest.128.6_suppl.628S
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Extract

In severe pulmonary arterial hypertension (PAH), chronic pressure and volume overload alters right ventricle (RV) geometry (ie, hypertrophy and dilation). As a consequence, the amount of space taken by the RV in patients with PAH within the pericardium increases, causing a leftward ventricular septum bowing. This phenomenon is most markedly observed during early left ventricular (LV) diastole, impeding LV diastolic filling.1 As a consequence, LV end-diastolic volume will be reduced, altering the LV contraction function, as described by the Frank Starling mechanism.24 The aim of our study was to investigate whether a prolonged RV systolic contraction time contributes to leftward septum bowing and the hemodynamic consequences of this interventricular interaction in pulmonary hypertension.

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