Assessment of left ventricular function in schistosomiasis.

Inspite of the fact that the haemodynamic changes in the right ventricle in schistosomal disease received proper attention, left ventricular changes were not equally assessed. That the left ventricle could suffer in bilharzial disease is a possibility, probably due to the development of shunts and toxic myocarditis. In this wor5, left ventricular functions were studied using the rate of maximum rise of intraventricular pressure (kp/dt) as an index of contractility. The study included 10 normal controls, 5 cases with bilharzial liver fibrosis and no ascites or cor pulmonale, 10 cases with BLF, and ascites but no cor pulmonale, and 10 cases with bilharzial cor pulmonale. Diminished dp/dt values were obtained in 8 out of the 10 cases of bilharzial cor pulmonale, in whom the left ventricular pressure curve also showed distortion and delay in the descending limb of the isometric relaxation phase, denoting defective contractility of the left ventricle, and probably a diastolic volume overload in these cases. In BLF with or without ascites, the dp/dt values were surprisingly increased possibly due to increased catecholamines in these cases secondary to ineffective destruction in the liver suffering from parenchymatous disease. The left ventricle is thus shown to suffer in bilharzial disease particularly in cases with bilharzial cor pulmonale.