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European Heart Journal 1993 14(7):876-884;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Right atrial contractile performance in patients with myocardial infarction

T. NODA, M. ARAKAWA, T. TAKAYA, T. NAGANO, K. KAGAWA, H. MIWA and S. HIRAKAWA

The Second Department of Internal Medicine, Gifu University School of Medicine Gifu, Japan

Received 27 May 1992; revised 15 December 1993; .

Correspondence: Toshiyuki Noda, MD, The Second Department of Internal Medicine, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu, Gifu, Japan 500

Abstract

To evaluate right atrial (RA) contractile performance in patients with myocardial infarction, we validated a cineangiographic method of RA volume measurement, and investigated RA volume change in ‘normal’ individuals and patients with a previous myocardial infarction. Sixteen silicone rubber RA casts made from human cadavers were filmed in the postero-anterior and left lateral projections. The cast volumes calculated following Simpson's rule were in good agreement with those measured by water replacement (r=0.992, P<.001). At cardiac catheterization, biplane RA cineangiography was performed in 19 ‘normal’ individuals (N group), in 14 patients with a previous antero-septal infarction (AM1 group) and in seven patients with aprevious inferior infarction (IMI group). The RA volume-time curve was constructed at 20–40 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, tended to be larger in both the AMI and IMI groups compared with ‘normal’ individuals. The RA ejection volume was significantly larger in both the AMI (18.4 ± 2.1 ml. m–2, 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 (range from 26 to 36ml.m–2) (18.6±2.1, P<0.01, 18.2±2.0, P<0.01, 14.7±1.9, respectively). These results suggest that RA contraction increases in patients with myocardial infarction by increasing both the ‘preload’ and ‘contractility’ of the RA.

Key Words: Right atrial angiography • right atrial ejection fraction • right atrial preload • myocardial infarction


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