Right atrial contractile performance in patients with myocardial infarction |
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Authors: | NODA, T. ARAKAWA, M. TAKAYA, T. NAGANO, T. KAGAWA, K. MIWA, H. HIRAKAWA, S. |
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Affiliation: | The Second Department of Internal Medicine, Gifu University School of Medicine Gifu, Japan |
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Abstract: | To evaluate right atrial (RA) contractile performance in patientswith myocardial infarction, we validated a cineangiographicmethod of RA volume measurement, and investigated RA volumechange in normal individuals and patients witha previous myocardial infarction. Sixteen silicone rubber RAcasts made from human cadavers were filmed in the postero-anteriorand left lateral projections. The cast volumes calculated followingSimpson's rule were in good agreement with those measured bywater replacement (r=0.992, P<.001). At cardiac catheterization,biplane RA cineangiography was performed in 19 normalindividuals (N group), in 14 patients with a previous antero-septalinfarction (AM1 group) and in seven patients with apreviousinferior infarction (IMI group). The RA volume-time curve wasconstructed at 2040 ms intervals for one cardiac cycle.RA volume at the beginning of the atrial contraction (RAVd),which was defined as the preload of the RA, tendedto be larger in both the AMI and IMI groups compared with normalindividuals. The RA ejection volume was significantly largerin both the AMI (18.4 ± 2.1 ml. m2, P <0.01)and IMI groups (l9.4±2.8, P<0.01) than in the N group(14.5±1.9), even for a comparable level of RAVd (rangefrom 26 to 36ml.m2) (18.6±2.1, P<0.01, 18.2±2.0,P<0.01, 14.7±1.9, respectively). These results suggestthat RA contraction increases in patients with myocardial infarctionby increasing both the preload and contractilityof the RA. |
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Keywords: | Right atrial angiography right atrial ejection fraction right atrial preload myocardial infarction |
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