Circulation, Vol 74, 230-238, Copyright © 1986 by American Heart Association
M Feneley and T Gavaghan
Cross-sectional echocardiographic measurements of normalized septal
curvature (NSC), systolic anterior motion of the center of the left
ventricular cavity (CAM), and the M mode ratio of left ventricular
posterior wall epicardial motion (PEM) to posterior wall thickening (PWT)
were made in eight normal subjects, 16 patients with right ventricular
volume overload (RVVO) and five with pressure overload (RVPO). Paradoxical
M mode septal motion was confined to early systole in six patients with
RVVO (group I) and was sustained in 10 (group II). Similar end-diastolic
septal flattening was observed in RVVO group I (NSC 0.50 +/- 0.16 [SD]) and
group II (0.49 +/- 0.23) when compared with the normal group (0.83 +/-
0.07, both p less than .005). NSC increased in both RVVO groups during the
first one-third of systole (p less than .002) to values not significantly
different from normal, but did not change significantly thereafter. CAM in
RVVO group II (5.4 +/- 2.2 mm) exceeded CAM in both the normal group (1.8
+/- 1.9 mm, p less than .001) and group I (2.1 +/- 1.4 mm, p less than
.005). Similarly, the PEM/PWT ratios in group II (mean 2.94; range 2.13 to
8.0) exceeded those in both the normal group (mean 1.59; range 1.11 to
2.13, p less than .01) and group I (mean 1.32; range 1.10 to 1.67, p less
than .01). In the RVPO group, CAM was significant, the PEM/PWT ratios were
lower than normal (p less than .01), and marked end-diastolic septal
flattening was incompletely corrected during early systole, after which the
septum was flattened further until end-systole (p less than .005).(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
Paradoxical and pseudoparadoxical interventricular septal motion in patients with right ventricular volume overload
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