{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T23:02:35Z","timestamp":1769122955011,"version":"3.49.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1995,8,15]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            Left ventricular ejection fraction has been reported to be depressed in patients with right ventricular volume overload (RVVO) due to Ebstein\u2019s anomaly and uncomplicated atrial septal defect, whereas it is usually preserved in right ventricular pressure overload (RVPO) due to congenital pulmonic stenosis. In the present study, we examined the hypothesis that the differential timing of active displacement of the ventricular septum into the left ventricle in RVPO (end systole) and RVVO (end diastole) results in opposite effects of RVPO and RVVO on left ventricular ejection fraction.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            Ten patients with severe tricuspid regurgitation after tricuspid valve resection for endocarditis and 10 patients with primary pulmonary hypertension were studied as models of isolated RVVO and RVPO, respectively. Left ventricular ejection fraction, end-diastolic volume, and regional systolic shortening were measured with the use of echocardiographic techniques in these 20 patients and 10 healthy control subjects. In RVPO, despite marked underfilling of the left ventricle relative to the healthy control subjects (end-diastolic volume, 48\u00b126 versus 77\u00b120 mL;\n            <jats:italic>P<\/jats:italic>\n            &lt;.02), left ventricular ejection fraction was similar to that of the control subjects (56\u00b15% versus 60\u00b14%;\n            <jats:italic>P<\/jats:italic>\n            =.07) and only 1 of 10 RVPO patients had an ejection fraction of less than 50%. In contrast, in RVVO the left ventricle was volume replete (end-diastolic volume, 84\u00b126 versus 77\u00b120 mL;\n            <jats:italic>P<\/jats:italic>\n            =NS), but left ventricular ejection fraction was significantly depressed (51\u00b14% versus 60\u00b14%,\n            <jats:italic>P<\/jats:italic>\n            &lt;.001) compared with the control subjects, and 4 of 10 RVVO patients had an ejection fraction of less than 50%. Analysis of systolic fractional shortening along two perpendicular short-axis diameters and the mutually orthogonal long axis demonstrated isolated augmentation of fractional shortening in the ventricular septal\u2013to\u2013posterolateral free wall dimension in RVPO (47.4\u00b113.7% versus 34.2\u00b113.1%,\n            <jats:italic>P<\/jats:italic>\n            &lt;.05) and isolated depression of fractional shortening along that same dimension in RVVO (13.7\u00b111.8% versus 34.2\u00b113.1%,\n            <jats:italic>P<\/jats:italic>\n            &lt;.001) compared with the control subjects.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            End-systolic leftward ventricular septal shift in RVPO results in isolated augmentation of systolic shortening in the septal\u2013to\u2013free wall dimension, whereas end-diastolic leftward ventricular septal shift in RVVO results in isolated reduction in systolic shortening in the septal\u2013to\u2013free wall dimension. As a result, despite relative underfilling of the left ventricle in RVPO, resting left ventricular ejection fraction is preserved, whereas ejection fraction is depressed for the volume-replete left ventricle of patients with RVVO.\n          <\/jats:p>","DOI":"10.1161\/01.cir.92.4.819","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:34:42Z","timestamp":1339461282000},"page":"819-824","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":133,"title":["Pressure and Volume Loading of the Right Ventricle Have Opposite Effects on Left Ventricular Ejection Fraction"],"prefix":"10.1161","volume":"92","author":[{"given":"Eric K.","family":"Louie","sequence":"first","affiliation":[{"name":"From the Division of Cardiology (E.K.L., S.S.L., S.I.R.), Loyola University Medical Center, Maywood, Ill; Division of Cardiology (B.H.B.), Harbor-UCLA Medical Center, Torrance, Calif; Division of Cardiothoracic Surgery (S.L.), New England Deaconess Hospital, Harvard Medical School, Boston, Mass; and Section of Cardiology (S.R.), University of Illinois (Chicago)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve S.","family":"Lin","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (E.K.L., S.S.L., S.I.R.), Loyola University Medical Center, Maywood, Ill; Division of Cardiology (B.H.B.), Harbor-UCLA Medical Center, Torrance, Calif; Division of Cardiothoracic Surgery (S.L.), New England Deaconess Hospital, Harvard Medical School, Boston, Mass; and Section of Cardiology (S.R.), University of Illinois (Chicago)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra I.","family":"Reynertson","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (E.K.L., S.S.L., S.I.R.), Loyola University Medical Center, Maywood, Ill; Division of Cardiology (B.H.B.), Harbor-UCLA Medical Center, Torrance, Calif; Division of Cardiothoracic Surgery (S.L.), New England Deaconess Hospital, Harvard Medical School, Boston, Mass; and Section of Cardiology (S.R.), University of Illinois (Chicago)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce H.","family":"Brundage","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (E.K.L., S.S.L., S.I.R.), Loyola University Medical Center, Maywood, Ill; Division of Cardiology (B.H.B.), Harbor-UCLA Medical Center, Torrance, Calif; Division of Cardiothoracic Surgery (S.L.), New England Deaconess Hospital, Harvard Medical School, Boston, Mass; and Section of Cardiology (S.R.), University of Illinois (Chicago)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidney","family":"Levitsky","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (E.K.L., S.S.L., S.I.R.), Loyola University Medical Center, Maywood, Ill; Division of Cardiology (B.H.B.), Harbor-UCLA Medical Center, Torrance, Calif; Division of Cardiothoracic Surgery (S.L.), New England Deaconess Hospital, Harvard Medical School, Boston, Mass; and Section of Cardiology (S.R.), University of Illinois (Chicago)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Rich","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (E.K.L., S.S.L., S.I.R.), Loyola University Medical Center, Maywood, Ill; Division of Cardiology (B.H.B.), Harbor-UCLA Medical Center, Torrance, Calif; Division of Cardiothoracic Surgery (S.L.), New England Deaconess Hospital, Harvard Medical School, Boston, Mass; and Section of Cardiology (S.R.), University of Illinois (Chicago)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(86)80300-X"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90311-C"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90056-S"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0033-0620(81)90022-0"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.18.2.209"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(76)90152-1"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(75)90480-4"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.63.6.7226477"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.75.2.3802438"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90451-P"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90724-N"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90945-8"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(89)90307-0"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(88)91221-0"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(87)90921-5"},{"key":"e_1_3_1_16_2","unstructured":"Nootens M Kaufmann E Wolfkiel C Rich S. 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