Theoretical consideration for the assessment of the left ventricular systolic function on the bases of the end-systolic stress-volume relation

documented SCD,recruited from the Rio de Janeiro SCD center, which follows a cohort of more than 1200 patients. Over a 2 years period we studied 112 patients (mean age, 34 years(6-48); male/female (42/70). They were examined according to their clinical findings and were studied by chest x-ray, eletrocardiography and two-dimensional and doppler cardiac ultrasound. The most frequently clinical abnormalities were palpitation(70%), acute and atypical chest pain(65%), dyspnea(28%), arritmias(28%), systolic murmurs(14%), and others. The most common echocardiographic features were found in the left heart, as manifested primary by increased left ventricular mass, with preservation of systolic function(15%), isolated enlarged left atrium(60%) and associated with left ventricular dilatation(20%)and systolic left ventricular disfunction(4%). Recent studies report that pulmonary hypertension(PH) is thought to occur in 30% of clinical patients with SCD and 40% mortality at 22 months after detection of elevated pulmonary artery pressures in SCD patients. We considered this finding the most important one in our group because mortality rates of patients with PH are significantly increased as compared to patients without PH and we detected up to 75% of PH in our group of patients with maximal systolic pulmonary artery pressure range from 30 to 90 mmHg. We concluded that echocardiography could be the most important and relevant feature to determine the prevalence and prognosis of secundary pulmonary hypertension in patients with SCD.