PULSED DOPPLER-ECHOCARDIOGRAPHY EVIDENCE OF IMPAIRED LEFT-VENTRICULARFILLING IN CYANOTIC ADULTS WITH NONRESTRICTIVE VENTRICULAR SEPTAL DETECTS WITH AND WITHOUT PULMONARY VASCULAR OBSTRUCTIVE DISEASE

Adults with a nonrestrictive ventricular septal defect are characteriz ed by cyanosis, systemic right ventricular hypertension, and, in most cases, normal systolic function of both the right and left ventricles. (1,2) Ultrasonic tissue characterization, however, revealed abnormal c yclic variation of integrated backscatter, suggesting alterations in m yocardial structure in these patients.(2) Diastolic filling of the lef t ventricle has not been characterized, but may also be abnormal.