Abstract
Measurements of the right ventricular volume were performed using biplane cineangiocardiography on 17 patients with mitral stenosis, ranging in age from 34 to 62. The right ventricular end-diastolic volume index ranged from 69 to 130 ml/m2 (99 ± 18, mean ± SDM), and the right ventricular ejection fraction ranged from 0.33 to 0.69 (0.51 ± 0.08). There was an inverse relationship between the right ventricular end-diastolic volume index and the right ventricular ejection fraction (r=-0.52, p < 0.05). The cardiac index measured by the dye-dilution method ranged from 1.61 to 4.40 L/min/m2 (2.56 ± 0.72) and correlated with the right ventricular ejection fraction (r=0.78, p < 0.001). The right ventricular end-diastolic volume was larger in 11 patients with tricuspid regurgitation than those without (p < 0.05). It was larger in 11 patients with atrial fibrillation than those with sinus rhythm (p < 0.05). The right ventricular ejection fraction was lower in 8 patients with low cardiac output (0.47 ± 0.08) than those with normal cardiac output (0.47 ± 0.08 vs 0.55 ± 0.07, p < 0.05). It was lower in 11 patients with atrial fibrillation than those with a sinus rhythm (0.48 ± 0.07 vs 0.57 ± 0.09, p < 0.05). The right ventricular ejection fraction was also lower in 7 patients with restenosis of the mitral valve following a commissurotomy than those without a previous operation (0.46 ± 0.08 vs 0.55 ± 0.07, p < 0.02). The left ventricular ejection fraction was lower in 8 patients with low cardiac output than those with a normal one (0.49 ± 0.09 vs 0.56 ± 0.04, p < 0.05). These results indicate that the right ventricular function is abnormally depressed in patients with mitral stenosis associated with low cardiac output.
