Elsevier

American Heart Journal

Volume 98, Issue 6, December 1979, Pages 742-751
American Heart Journal

Experimental and laboratory report
The influence of left ventricular filling pressure on atrial contribution to cardiac output

https://doi.org/10.1016/0002-8703(79)90473-3Get rights and content

Abstract

The influence of left ventricular filling pressure on the atrial contribution to cardiac output was evaluated in 18 patients. An inverse relationship between filling pressure and atrial contribution was seen in studies done at baseline (PCW (r = −.53, p < .025), as well as in studies done after PCW was modified by volume expansion and/or nitrates (r = −.53, p < .005). At baseline, atrial contribution averaged 9.3 ± 1.3 c.c./M.2 in patients with PCW < 20 mm. Hg, while it was only 2.4 ± 1.2 c.c./M.2 in patients with PCW ≥ 20 mm. Hg (p < .005). Atrial contribution was significantly greater in patients who had no history of heart failure when they were volume loaded to a PCW above 20 mm. Hg than in patients with impaired ventricular function whose baseline PCW was above 20 mm. Hg. Thus, atrial contribution tends to be less effective in augmenting cardiac output when filling pressure is already elevated, particularly in patients with impaired left ventricular function.

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    This work was supported in part by National Heart, Lung, and Blood Institute Program Project Grant HL 06285.

    Dr. Greenberg is presently Asst. Professor of Medicine at the University of Oregon Health Sciences Center, Portland, Oreg. 97201.

    ∗∗

    Dr. Werner is presently Director of the Coronary Care Unit, Harborview Medical Center, Seattle, Wash. 98122.

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