Gao Ying, He Jianguo, Liu Yunzhong, Cheng Rui, Cui Xizhong

(Fu Wai Hospital of Cardiovascular Diseases, CAMS)

ABSTRACT : We investigated thechanges of left heart function in 28 patients with cor pulmonale by three non-invasivemethods, namely, radionuclide ventriculography, Doppler echocardiography and right chestelectric admittance plethysmography and the results were compared. The radionuclideventriculography revealed a significantly lower left ventricular peak filling rate (LVPFR); the Doppler echocardiography showed lower peak E wave, higher peak A wave and aE/A ratio<1 on the diastolic trans-mitral valve blood flow spectrum as compared withtheir respective normal values. These data suggested the existance of diastolicdysfunction of the left ventricle in patients with cor pulmonale. In the same group ofpatients, right chest electric admittance plethysmography disclosed Hc/Hz≥65% in 22patients (78.6%) and Q-j/j-z≥50% in 14(50%). These indicated increase of the preload ofleft ventricle which was basically in accordance with the findings of the other twomethods. This indicated that right chest electric admittance plethysmography was a usefultechnique in evaluation of the left heart function. In patients with cor pulmonale, thediastolic function of the left ventricle was probably jeopardized by several factors,including chronic anoxemia and acidosis, and the geometric disfiguration of left ventricledue to compression from the enlarged right ventricle insid of the pericardial sac and bythe protruding of the hypertrophic interventricular septum toward left side duringdiastole. The last event was attributed to increased pressure gradient between twoventricles during diastole because of higher diastolic pressure in the right ventrcle andinadequate filling of the left ventricle.

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