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Have been studied 51 patients with aortic incompetency (AI), 46 with mitral insufficiency (MI) and 31 with congestive cardiomyopathy (CM) as example of a primitive myocardial lesion. The mean parametres calculated were: the left ventricular end-diastolic pressure (LVEDP), the ventricular volumes, the ejection fraction (EF), the end-sistolic pressure-volume ratio (Emax) and the eccentricity. In the chronic volume overload, the relationship between the pump performance and the contractility (EF-Emax) is parabolic with an initial plateau (myocardial failure without circulatory failure); the EF-Emax relationship, in the CM, is linear without a plateau. The LVEDP is a limiting factor of the pump-contractility relationship in the AI: for the same value of the contractility, the pump function is greater depressed if the LVEDP is 25 mmHg (loss of the preload modulation); in the MI and CM the depression of the pump performance is a function only of the depressed contractility. The end-systolic eccentricity is correlated with Emax: the changes in the geometrical shape of the left ventricular chamber is due to the depressed contractility.
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