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(Circulation. 1999;100:465-467.)
© 1999 American Heart Association, Inc.

Brief Rapid Communications

Asymmetry of Right Ventricular Enlargement in Response to Tricuspid Regurgitation

Sandra I. Reynertson, MD; Ramesh Kundur, MD; G. Martin Mullen, MD; Maria Rosa Costanzo, MD; Thomas L. McKiernan, MD; Eric K. Louie, MD

From the Division of Cardiology, Loyola University Medical Center, Maywood, Ill.

Correspondence to Eric K. Louie, MD, Professor of Medicine, Associate Director, Division of Cardiology, Loyola University Medical Center, Maywood, IL 60153.

Background—Analysis of right ventricular adaptation to tricuspid regurgitation was studied in 10 heart transplant recipients following inadvertent endomyocardial biopsy disruption of the tricuspid apparatus.

Methods and Results—Echocardiography demonstrated progressive diastolic right ventricular cavity enlargement (19.5±5.0 to 30.3±5.4 cm², P<0.0002), with disproportionate elongation along the midminor axis (3.5±0.6 to 5.0±0.5 cm, P<0.001). As the right ventricle remodeled to more spherical (and less elliptical) proportions, the end-diastolic right ventricular midminor axis/long axis ratio increased significantly from 0.52±0.10 to 0.68±0.07, P<0.005.

Conclusions—Ventricular enlargement due to right ventricular volume overload results in disproportionate dilation along the free wall to septum minor axis.

Key Words: ventricles • regurgitation • right ventricular volume overload • tricuspid regurgitation • orthotopic heart transplantation

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