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Chest. 2011 Aug;140(2):310-316. doi: 10.1378/chest.10-1750. Epub 2011 Feb 17.

Regional left ventricular systolic function and the right ventricle: the multi-ethnic study of atherosclerosis right ventricle study.

Author information

1
Department of Medicine, University of Pennsylvania School of Medicine Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine Philadelphia, PA.
2
Department of Medicine Johns Hopkins School of Medicine, Baltimore, MD.
3
Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, MD.
4
Department of Medicine, University of Pennsylvania School of Medicine Philadelphia, PA; Penn Cardiovascular Institute, University of Pennsylvania School of Medicine Philadelphia, PA.
5
Department of Medicine, Anschutz Medical Center, University of Colorado Denver, Aurora, CO.
6
Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA.
7
Department of Epidemiology, Mailman School of Public Health, and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY.
8
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine Philadelphia, PA.
9
Department of Medicine, University of Pennsylvania School of Medicine Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine Philadelphia, PA; Penn Cardiovascular Institute, University of Pennsylvania School of Medicine Philadelphia, PA. Electronic address: kawut@mail.med.upenn.edu.

Abstract

BACKGROUND:

Dysfunction of the interventricular septum has been implicated in right ventricular (RV) failure. However, little is known about the relationship between ventricular septal and RV function in patients without clinical cardiovascular disease. We hypothesized that better septal function would be associated with higher RV ejection fraction and lower RV mass and volume by cardiac MRI.

METHODS:

In the Multi-Ethnic Study of Atherosclerosis (MESA), cardiac MRI was performed on community-based participants without clinical cardiovascular disease. Images were analyzed by the harmonic phase method to measure peak circumferential systolic midventricular strain for each wall (anterior, lateral, inferior, and septal). Multivariable linear regression and generalized additive models were used to assess the relationship between septal strain and RV morphology.

RESULTS:

There were 917 participants (45.7% women) with a mean age of 65.7 years. Better septal function was associated with higher RV ejection fraction in a nonlinear fashion after adjustment for all covariates (P = .03). There appeared to be a threshold effect for the contribution of septal strain to RV systolic function, with an almost linear decrement in RV ejection fraction with septal strain from -18% to -10%. Septal function was not related to RV mass or volume.

CONCLUSIONS:

Interventricular septal function was linked to RV systolic function independent of other left ventricular regions, even in individuals without clinical cardiovascular disease. This finding confirms animal and human research suggesting the importance of septal function to the right ventricle and implies that changes in septal function could herald RV dysfunction.

TRIAL REGISTRY:

ClinicalTrials.gov; No.: NCT00005487; URL: www.clinicaltrials.gov.

PMID:
21330384
PMCID:
PMC3148792
DOI:
10.1378/chest.10-1750
[Indexed for MEDLINE]
Free PMC Article
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