Our objective was to establish normal ranges of left and right ventricular mass and function with cine magnetic resonance imaging (MRI) and to determine gender differences. Seventy-five healthy subjects (age range 8-55, mean 28 yr) were studied with cine MRI. Ten dogs were imaged for autopsy validation with a mean difference between actual and MRI-determined mass of 0.2 A +/- 8.4 g. Intraobserver and interobserver variability and interstudy variability were 5-6%. All parameters were significantly different between males and females except ejection fraction and the left ventricular mass to end-diastolic volume ratio. Agreement with published autopsy series, including gender differences, was excellent. This study presents normative MRI data that can be used for comparing individual patients and for further study of right and left ventricular interaction.

Normal human right and left ventricular mass, systolic function, and gender differences by cine magnetic resonance imaging.

Right ventricular ischemia in patients with primary pulmonary hypertension.

Although right heart failure (RHF) contributes to 20% of all cardiovascular complications, most of the information available on RHF in general is based on the experiences with left heart failure. This study on RHF investigates changes in antioxidants and oxidative stress which are suggested to play a role in the transition from hypertrophy to failure. RHF subsequent to pulmonary hypertension was produced in rats by a single injection of monocrotaline (MCT, 60 mg/kg, i.p.). Based on hemodynamic, clinical and histopathologic observations, the animals were grouped in three functional stages at 1-, 2- and 6-week post-injection periods. In the 1-week group, RV pressure overload and hypertrophy, and a mild increase in antioxidant enzymes was seen. In the 2-week group, compensated HF, a significant increase in antioxidant enzymes, an increase in septal (IVS) wall thickness and leftward displacement of IVS without change in LV free wall were seen. In the 6-week group, lung and liver congestion, RVF and dilation, a decrease in antioxidant enzyme activities, increase in lipid peroxidation and severe bulging of the IVS into the left ventricle were seen. These changes in the hemodynamic, biochemical and histopathologic characteristics suggest that in early stages of MCT-induced pulmonary hypertension at 1 and 2 weeks, RV hypertrophy was accompanied by sustained hemodynamic function and an increase in antioxidant reserve. In the later stage at 6 weeks, clinical RHF was associated with abnormalities of the right heart systolic and diastolic function along with a decrease in antioxidant reserve. These biphasic changes in RV antioxidant enzymes, i.e. an increase during hypertrophy and a decrease in failure may suggest a role of oxidative stress in the pathogenesis of right ventricular dysfunction.

Antioxidant and oxidative stress changes in experimental cor pulmonale.

Thallium-201 myocardial scintigraphy.

PURPOSE: To assess the accuracy of cine magnetic resonance (MR) imaging with a segmented true fast imaging with steady-state precession (FISP) technique for right ventricular (RV) mass quantification. MATERIALS AND METHODS: Fourteen dogs were imaged with a 1.5-T clinical MR imaging unit by using an electrocardiographically gated true FISP sequence. Contiguous segmented k-space cine images were acquired from the base of the RV to the apex during suspended respiration (repetition time msec/echo time msec, 3.2/1.6; section thickness, 5 mm; in-plane resolution, 1.0 × 1.3 mm2). After imaging, each dog was sacrificed, and the RV free wall was isolated and weighed. Each MR imaging data set was analyzed twice by each of two independent observers who were blinded to the results of RV mass measurement at autopsy, and the mass measurements at MR imaging were compared with the autopsy results by using linear regression and Bland-Altman analysis. RESULTS: RV mass measurements calculated by using the true FISP cine MR ...

Accurate quantification of right ventricular mass at MR imaging by using cine true fast imaging with steady-state precession: study in dogs.

The usefulness of thallium-201 myocardial imaging in assessing right ventricular (RV) overloading was evaluated and compared with the electrocardiographic and hemodynamic measurements. Multiple unprocessed photoscans were obtained using a gamma camera in 47 patients who had chronic RV overload, including 28 subjects with pressure overload, 14 with volume overload and five with pressure and volume overload.With pressure overload the degree of RV visualization (RVV) was correlated with elevation of RV systolic pressure. With volume overload the RV free wall was visualized in all patients, and RVV was correlated with the increment in pulmonary–to–systemic flow ratio. Pressure and volume overload could be differentiated from the morphologic characteristics of myocardial image. With pressure overload the interventricular septum appeared straight. With volume overload the RV cavity appeared to be dilated and the interventricular septum convex to the right ventricle.Myocardial images were compared with ECG findings of RV hypertrophy in cases with pressure overload. RVV intensity correlated with the number of criteria (Sokolow and Lyon) satisfied in each tracing. The sensitivity of myocardial imaging for diagnosis of RV pressure overload was 93.3%, higher than that of ECG criteria for RV hypertrophy. We conclude that thallium-201 myocardial imaging is sensitive and reliable in assessing RV overload.

Thallium-201 myocardial imaging to evaluate right ventricular overloading.

Thallium-201 myocardial scintigraphic studies were performed on 24 patients with chronic right ventricular overload before and after surgical correction of haemodynamic overload. The ages of the patients ranged from 20 to 65 years (mean 39 years) at operation. The degree of right ventricular visualisation remained essentially unchanged in an early postoperative study (four to 60 days), though a decrease in right ventricular cavity size was noted in patients with right ventricular volume overload. On later follow-up (18 to 36 months), thallium uptake in the right ventricle was definitely less than before operation in all 13 patients studied at this time. Because thallium-201 radioactivity reflects myocardial blood flow and mass, our study indicates that right ventricular hypertrophy is largely reversible. Thus, thallium-201 myocardial scintigraphy can be used to assess non-invasively regression of right ventricular hypertrophy in patients with right ventricular overload.

https://heart.bmj.com/content/heartjnl/48/4/372.full.pdf

Postoperative thallium-201 myocardial images. Evidence of regression of right ventricular hypertrophy in man.

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Thallium-201 myocardial imaging to evaluate right ventricular overloading.

Postoperative thallium-201 myocardial images. Evidence of regression of right ventricular hypertrophy in man.