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Exaggerated Respiratory Variation in Left Ventricular Ejection Time during Lax Pericardial Effusion
Abstract
In 20 consecutive patients with echocardiographic pericardial effusions and no pulsus paradoxus or other signs of cardiac embarrassment the left ventricular ejection time fell (ΔLVET) during inspiration by 18.3 ± 2.47 (SE) ms, greatly exceeding mean inspiratory ΔLVET in normal subjects (7.0 ms). Median and mode ΔLVET were each 15.0 ms, with ΔLVET less than 10 ms and more than 25 ms in only 1 patient each. With a single exception, the magnitude of the abnormal ΔLVET was least in patients with minimal to small effusions. Ejection time indices were normal during expiration and low during inspiration, indicating diminished stroke volume during inspiration only. Thus, even without clinical and echocardiographic signs of cardiac compression, the presence of pericardial fluid clearly exaggerated respiratory effects on left ventricular function but not to the degree characteristic of overtly compressing (tamponading) fluid. The consistent exaggeration of ΔLVET during even small pericardial effusions is thus of physiologic interest and may be of diagnostic value.
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173562 Cardiology 1983;70:1–5Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.