Biventricular systolic function in young lambs subject to chronic systemicright ventricular pressure overload

In various clinical situations of congenital heart disease, the right ventr icle (RV) is subject to a chronic systemic pressure overload which affects biventricular function and may progress to the development of RV failure. Y oung lambs (2-3 wk old) underwent adjustable pulmonary artery banding (PAB) at systemic (aortic) level for 8 wk. Biventricular function was determined by using load-independent indexes of global ventricular contractile perfor mance by the end-systolic pressure-volume relationship (ESPVR) using the co nductance catheter at baseline and during dobutamine infusion. PAB resulted in a significant fivefold increase in RV end-systolic pressure (12-64 mmHg ) and a doubling of the RV-to-left ventricular (LV) wall thickness ratio (P < 0.01). RV global contractile performance increased significantly, as ind icated by an increased slope of the ESPVR. Compared with age-matched contro l lambs, cardiac output decreased from 2.6 to 1.6 l/min (P < 0.05) whereas heart rates were equal. In contrast with RV volume, LV volume decreased sig nificantly after PAB (P < 0.01), whereas the LV-ESPVR slope was unchanged. In the PAB group, the RV, but not the LV, showed a reduced response to dobu tamine. We concluded that chronic RV pressure overload for 8 wk results in diminished pump function despite compensatory increased RV global contracti le performance.