Recreating diasporic identity and community: Examination of transgender and nonbinary latinx healing from family rejection

The purpose of this study was to explore the experience of healing from family rejection among transgender and nonbinary Latinx individuals. Participants were asked how they navigated family dynamics related to gender identity and specific behaviors or resources that promoted their healing from experiences of family rejection. Data from 12 interviews with Latinx nonbinary and transgender adults were analyzed through a critical-constructivist grounded theory method resulting in a hierarchy composed of three clusters related to the core category (healing from family rejection leads to the recreation of diasporic identity and community as one learns to live authentically in their ethnic/racial gendered expression). These clusters included recreation of the family system, community-based cultural healing, and autonomy in trans identity and psychological well-being. Relevant contributions to research and implications for psychologists are reviewed: (a) Latinx diasporic identity formation is facilitated through the reconstruction of familial relationships and cultural healing, and (b) chosen family and supportive community networks may adopt the responsibility of ethnic-racial socialization after proximity to family of origin is lost. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Exploring the Efficacy of an Online Intervention in Processing Experiences of Heterosexism Among Autistic-LGBQ + Individuals

This experimental study explored the use of online expressive writing interventions to cope with distress from heterosexist events among a sample of autistic-LBGQ + individuals. This study included an open writing condition and an emotion focused therapy guided writing condition. Over 89% of the participants indicated that the writing exercises were helpful in processing the event, with significant decreases for measures of depressive and trauma/stressor symptoms. A thematic analysis identified specific aspects of each condition that were helpful for participants in coping with heterosexist distress, such as the development of insight through the emotion-focused exercises. This low-demand exercise is promising as a solo exercise or as a therapy homework assignment, especially given the accessibility of this online intervention for autistic-LGBQ + people.

"Tuned into a different channel": Autistic transgender adults' experiences of intersectional stigma

In this critical-constructivist grounded theory study, we interviewed 13 autistic-transgender, nonbinary, and/or gender diverse (TNG) individuals on the intersection of their autistic-TNG identities and how they resisted marginalization related to these experiences. Analysis revealed the experiences of living in a world that "doesn't seem quite set up the right way" and situated autistic-TNG experiences in complex set of intersectional processes that require navigating relationships, health care systems, and safety challenges living in a heterosexist, cissexist, and ableist society. Participants had to constantly assess the safety and disclosure of their identities in the face of oppressive systems while claiming space and creating community that affirmed them. We conclude by highlighting the importance of taking an intersectional lens to highlight the many positive aspects of being autistic and TNG, which have been largely absent in research and clinical dialogues. We provide some suggestions for providing culturally responsive mental health and ways neurotypical and cisgender people can begin to challenge ableist and cissexist narratives in their clinical practice and research, alongside autistic-TNG people. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The stench of bathroom bills and anti-transgender legislation: Anxiety and depression among transgender, nonbinary, and cisgender LGBQ people during a state referendum

Informed by structural stigma theory, this article presents the results of two studies that explored mental health experiences of transgender, nonbinary, and gender-diverse (TNG) individuals and cisgender lesbian, gay, bisexual, and queer (LGBQ) individuals (N = 523) prior to and following a state referendum to remove gender-based protections. In the Preelection Study, a path model explored relationships among individual factors (i.e., TNG identity, history of gender-based victimization), interpersonal variables (i.e., Referendum familiarity, exposure to Referendum-related messages, sexual orientation, and gender identity-specific social support), and mental health factors (i.e., Referendum-related anxiety and depressive symptomatology). Referendum-related anxiety mediated the relationships between TNG identity, gender-based victimization, sexual orientation and gender identity social support, and depressive symptomatology, explaining 40% of the variance in depressive symptomatology. Postelection, a subsample of participants (N = 117) was used to test a model of differences from pre- to postelection. Neither TNG identity nor victimization predicted Postelection mental health, however, Referendum-related anxiety and depressive symptomatology were significantly lower following the ballot vote that retained gender-based rights. Clinical implications suggest sexual and gender minorities may report increased anxiety in the face of anti-lesbian, gay, bisexual, transgender, and queer (LGBTQ) legislation, which may be associated with heightened symptoms of depression. TNG people and LGBTQ people with histories of gender-based victimization may be more at risk for mental health concerns related to anti-TNG legislation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The challenges and promises of transnational LGBTQ psychology: Somewhere over and under the rainbow

This article explores the influence of psychology developed in WEIRD (Western, educated, industrialized, rich, and democratic) contexts and its relationship to transnational lesbian, gay, bisexual, transgender, and queer (LGBTQ) concerns. It covers several points associated with an LGBTQ movement forward fallacy, including the limitations of identitarian methods of analysis; presumption of visibility as a necessary aspect of LGBTQ emancipation; the centering of oppression narratives in LGBTQ international scholarship; the assumption of the relevance and desirability of WEIRD concepts; and the difficulties in applying human rights discourses to achieve LGBTQ emancipation. A transnational LGBTQ psychology that honors the authentic lives of LGBTQ people and decolonizes and dismantles context-specific homophobia/transphobia-related stigma is discussed. Finally, the promising directions of transnational LGBTQ psychology through research directions, networking, and advocacy are described. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Emergence of a transnational LGBTI psychology: Commonalities and challenges in advocacy and activism

This contribution explores the historical developments of transnational lesbian, gay, bisexual, transgender, and intersex (LGBTI) psychology in Colombia, the Philippines, Russia, and South Africa in relationship to U.S. LGBT psychology. LGBTI psychology in these diverse contexts share commonalities but also have important variations in their development and focus within LGBTI concerns. The International Psychology Network for Lesbian, Gay, Bisexual, Transgender and Intersex Issues (IPsyNet) provides a model for international professional psychology collaboration and linkage on behalf of advocacy for LGBTI rights and sexual orientation and gender identity and/or expression concerns. Although there is the risk of transnational LGBTI psychology(ies) reproducing European-North American (Euro-N.A.) "homonationalism" and contributing to neo-colonization, these case examples illustrate the dynamic potential of transnational LGBTI psychology, including the possibilities of psychology to develop LGBTI psychologies drawing from indigenous as well as international structures and platforms, influencing Euro-N.A. models in the process. Finally, this article describes the promise and the limitations of transnational LGBTI psychology, including the role of human rights frameworks, as well as advocacy within professional psychology. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The role of gender-based violence, health worries, and ambivalent sexism in the development of women's gynecological symptoms

This article explored the role of a lifetime history of gender-based violence, ambivalent sexism, and gynecological health worries in the development of reproductive and sexual symptoms among women in Kyrgyzstan. Non-pregnant women who were patients of gynecological clinics (N = 143) participated in the study. A positive relationship between the experience of any type of violence (physical, sexual, and emotional) and number of gynecological symptoms was found. Hostile sexism was found to be a predictor of the number of reported symptoms. The number of gynecological health worries was found to fully mediate the relationship between history of gender-based violence and number of gynecological symptoms.

HIV Prevention in Gay Family and House Networks: Fostering Self-Determination and Sexual Safety

Many gay, bisexual, and transgender (GBT) people of color (POC) join house and/or constructed family communities, which serve as support networks composed mostly of other non-biologically related GBT/POC. These networks can decrease or increase the risk of exposure to HIV via multiple mechanisms (e.g., providing informal sexual safety education versus stigmatizing family members with HIV, encouraging sexual safety practices versus unsafe escorting, teaching self-care versus substance use) but act to support family members in the face of social and economic hardship. Researchers interviewed ten members of these social networks in the Boston metro area of the US and produced a saturated grounded theory analysis to explore the role of gay family/house networks in HIV risk management. While network members utilized HIV prevention resources, interviewees described how their efficacy was related to the intentions of leadership and strength of kinship boundaries within their community, economic opportunities, and communication skills. Clinical and research implications are discussed.

Differences Across Contexts

Minority stressors encountered by lesbian, gay, and bisexual (LGB) women are inherently connected to contextual experiences. Although there is a growing body of research on the benefits of gaining political rights and the costs of their denial, little research has focused on the effects of access to LGB-affirmative resources. In the current study with 1,017 women in same-sex relationships, we created profiles using latent class analysis to characterize the contexts in which participants were raised and the contexts in which they lived at the time of the study. We examined differences in interpersonal relationships, internalized heterosexism (IH), and outness across these profiles. Class 1 (28%) included participants who always lived in affirmative contexts with LGB-supportive resources. Class 2 participants (28%) always lived in more heterosexist contexts with few resources. Class 3 participants (44%) originally lived in more heterosexist contexts with few resources but shifted to more affirmative contexts. Class 3 individuals had greater social support and lower IH than Class 2 participants. Classes 1 and 3 had greater outness than Class 2. This study provides evidence linking IH to the lack of contextual supports. Our data also suggest that the quality of relationships for LGB women may remain strong even in heterosexist contexts. Actions that increase affirming resources will provide avenues for more positive identity development and interpersonal relationships for LGB individuals. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index .

The Use of Self-Pleasure: Masturbation and Body Image Among African American and European American Women

The current investigation examined the relationship between masturbation and body image among 96 women seeking services at a local family planning clinic in a mid-southern U.S. city. Participants completed a questionnaire that assessed body image and masturbatory practices. Ethnic differences were found with European American women reporting greater masturbation frequencies and higher rates of body dissatisfaction than African American women. Among European American women, there was a positive relationship between women's sexual self-pleasuring and positive body image. For African American participants, body image was not related to masturbation practice or frequency.

Predictors of Sexual Minority Youth's Reported Suicide Attempts and Mental Health

Lesbian, gay, and bisexual youth (LGBY) report higher rates of mental health concerns compared to heterosexual youth due to minority stressors. This study examined the interpersonal and intrapersonal variables that predict psychological distress and self-reported suicide attempts in a sample of 61 LGBY in the Mid-South, which is a highly overlooked regional area for LGBY research. Youth who lost friends when coming out were 29 times more likely to report suicide attempts, and those who experienced psychological maltreatment from caregivers were 9.5 times more likely to report a suicide attempt. Internalized heterosexism, feelings of guilt or shame, and psychological maltreatment from caregivers were significant predictors of depression and anxiety symptoms. This study highlights the importance of creating affirming spaces for LGBY, particularly in areas of the country that experience greater political oppression of sexual minorities, such as the Mid-South.

Accepting death as part of life: meaning in life as a means for dealing with loss among bereaved individuals

The purpose of this study was to investigate the relationship between the 3 dimensions of death acceptance (i.e., neutral, approach, and escape) and grief symptomatology, as well as whether the relationship between neutral acceptance and grief symptoms was mediated by meaning in life. Data were collected from 160 bereaved individuals. Only neutral acceptance was significantly associated with grief symptomatology; the relationship between the 2 variables was mediated by meaning in life. Participants who perceived death as a natural part of life reported having a greater sense of meaning in their lives, which, in turn, predicted lower grief symptomatology.

On-pump coronary artery bypass surgery in vascular Ehlers-Danlos syndrome

A 58-year-old woman with vascular Ehlers-Danlos syndrome (EDS; type IV) presented to a Canadian tertiary care emergency department with a non-ST elevation myocardial infarction. The patient failed medical therapy and after careful consideration of the options, elected to undergo urgent coronary artery bypass (CABG) surgery. To the best of our knowledge, this is the first reported case of a successful on-pump CABG surgery in a patient with vascular EDS.

African American Gay Family Networks: An Entry Point for HIV Prevention

Gay families are constructed support networks that gay, bisexual, and transgender individuals of color form, often in response to societal marginalization and rejection from biological families. Research on these family structures has been scarce, with little focus on the experience of African American gay family networks in the South. The current grounded theory qualitative study focused on the experiences of 10 African American male and transgender individuals between the ages of 18 and 29 from gay families in the Mid-South, and explored the ways these families addressed safe-sex issues and human immunodeficiency virus (HIV) risk prevention. Results revealed that families can play a role in either increasing HIV risk (e.g., ignoring HIV issues, encouraging such unsafe behaviors as exchanging sex for money or drugs, stigmatizing HIV-positive people) or decreasing it (e.g., intensive, family-level prevention efforts at safe-sex practices and family support for HIV treatment adherence). The potential of these family networks for HIV prevention and adherence efforts is considered.

Finding meaning in loss: the mediating role of social support between personality and two construals of meaning

Dimensions of personality may shape an individual's response to loss both directly and indirectly through its effects on other variables such as an individual's ability to seek social support. The mediating effect of social support on the relationship between personality (i.e., extraversion and neuroticism) and 2 construals of meaning (i.e., sense-making and benefit-finding) among 325 bereaved individuals was explored using path analysis. Supporting our hypotheses, social support mediated the relationship between personality and construals of meaning. Neuroticism was negatively and indirectly associated with both sense-making and benefit-finding through social support. Extraversion had a significant positive relationship to social support, which, in turn, mediated the impact of extraversion on both sense-making and benefit finding. The model explained 35% of the variance in social support, 19% of the variance in sense-making, and 25% of the variance in benefit-finding. Implications are discussed in light of existing theories of bereavement and loss.

Sexual minority women's gender identity and expression: challenges and supports

Sexual minority women were divided into four groups to study their gender identities (butch and femme), and gender expression (traditionally gendered and non-traditionally gendered women who do not identify as butch or femme). Experiences of heterosexist events (discrimination, harassment, threats of violence, victimization, negative emotions associated with these events), mental health (self esteem, stress, depression), and supports for a sexual minority identity (social support, outness, internalized homophobia) were examined across these groups. Findings suggested that butch-identified women experienced more heterosexist events than femme women or women with non-traditional gender expressions. There were no differences in mental health variables.

Out in the country: rural sexual minority mothers

Rural and urban sexual minority mothers' parenting experiences related to sexual orientation were compared. Participants were 414 mothers in same-sex relationships with at least one child under the age of 18 years living in their home who was planned with their current partner. Rural mothers were more likely to be biological parents and not adoptive parents. Rural mothers reported higher rates of discrimination from strangers and people in service or helping professions. Although outness for rural and urban mothers did not differ, for children, classmates' parents and neighbors were less likely to know the family's status in rural areas. Rural and urban mothers did not differ on internalized homophobia, social support, or stigma consciousness. Clinical and policy implications are discussed.

Lesbian, gay, and bisexual individuals' psychological reactions to amendments denying access to civil marriage

Political campaigns to deny same-sex couples the right to civil marriage have been demonstrated to increase minority stress and psychological distress in lesbian, gay, and bisexual (LGB) individuals (S. S. Rostosky, E. D. B. Riggle, S. G. Horne, & A. D. Miller, 2009). To further explicate the psychological reactions of LGB individuals to marriage amendment campaigns, a content analysis was conducted of open-ended responses from 300 participants in a national online survey that was conducted immediately following the November 2006 election. LGB individuals indicated that they felt indignant about discrimination; distressed by the negative rhetoric surrounding the campaigns; fearful and anxious about protecting their relationships and families; blaming of institutionalized religion, ignorance, conservative politicians, and the ineffective political strategies used by LGBT organizers; hopeless and resigned; and, finally, hopeful, optimistic, and determined to keep fighting for justice and equal rights. These 7 themes are illustrated and discussed in light of their implications for conceptualizing and intervening to address discrimination and its negative psychological effects.

Putting on Sunday Best: The Silencing of Battered Women Within Christian Faith Communities

This paper presents findings related to the silencing of battered women within Christian faith communities in Memphis, Tennessee, a large metropolitan area in the Mid-South region of the United States. Participants in this qualitative inquiry were 10 Christian identified women from diverse denominations and racial/ethnic and socioeconomic backgrounds who had experienced intimate partner violence. Data were analyzed according to grounded theory method. Findings illuminate mechanisms through which Christian beliefs about the sanctity of marriage and partner and community pressure to present as model Christians serve to shame and silence battered women. Findings are discussed in relation to stages that participants negotiated as they sought to create abuse-free lives.

Psychological distress, well-being, and legal recognition in same-sex couple relationships

Legal recognition of same-sex couple relationships provides at least some material benefits to couple members; however, few studies have examined the associations between legal recognition and psychological distress or well-being. Using an online survey sample of 2,677 lesbian, gay, bisexual (LGB) individuals, participants were placed in 4 groups: single, dating, in a committed relationship, and in a legally recognized relationship. Analyses revealed that participants in committed or legally recognized relationships reported less psychological distress (i.e., internalized homophobia, depressive symptoms, and stress) and more well-being (i.e., the presence of meaning in life) than single participants. Significant group differences and multivariate analyses indicated that participants in a legally recognized relationship reported less internalized homophobia, fewer depressive symptoms, lower levels of stress, and more meaning in their lives than those in committed relationships, even after controlling for other factors. The need for further research on the psychological benefits of legal relationship recognition for same-sex couples is discussed.

Effects of gender identity on experiences of healthcare for sexual minority women

While research examining healthcare experiences of sexual minority individuals is growing, thus far research has been limited on lesbian gender identity and its relationship to physical and mental health. This study explores access to and experiences of healthcare with a sample of 516 butch and femme identified lesbian and bisexual women. In comparison to femme-identified women, it was found that butch women had routine gynecological examinations significantly less frequently, perceived poorer treatment in healthcare settings, were more likely to be out within healthcare settings, placed more importance on securing LGBT-positive healthcare practitioners, and had more difficulty finding LGBT-positive medical doctors. No differences were found for mental health. The results suggest that butch women may be more at risk for physical health concerns than femme women, in particular those illnesses that can be prevented or treated with regular gynecological care (e.g., uterine or cervical cancer). Implications of the study include greater awareness among healthcare professionals of sexual minority gender identity in addition to sexual identity, and more support for butch-identified women to access vital healthcare services.

Relationship characteristics of women in interracial same-sex relationships

The purpose of this study was to examine the relationship characteristics of women in interracial same-sex relationships with respect to their current level of stress, internalized homophobia, perceived relationship equality, relationship satisfaction, and social support. Four groups were compared according to their current type of race relationship (ethnic minority women with White partners, White partners only, both ethnic minority partners, and White women with ethnic minority partners). No significant differences were found in terms of children and income; however, ethnic minority women with ethnic minority partners reported lower education attainment than the other groups. Relationally, there were no significant differences by race relationship for social support, relationship equality, relationship satisfaction, or stress. Internalized homophobia was lowest for interracial partnerships (ethnic minority paired with White partner). These findings are discussed in relationship to minority stress.

Sexual satisfaction and desire discrepancy in same sex women's relationships

We explored desire discrepancy and sexual satisfaction among a sample of 1072 women in same-sex relationships. Results indicated that those who reported problematic desire discrepancy in the relationship had lower frequency of sexual contact and were less satisfied in their sexual relationships than both women who reported nonproblematic desire discrepancy and women with equal experiences of desire. In addition, problematic desire discrepancy was predictive of sexual dissatisfaction above and beyond other relationship factors. The findings suggest that caution should be taken when working with women in same sex relationships to avoid assumptions that discrepancy in desire is necessarily indicative of lower sexual satisfaction.

Guilty or not? A path model of women's sexual force fantasies

This study estimated a path model of women's forceful sexual fantasies. Constructs examined were childhood sexual abuse, feminist beliefs, sexual guilt, erotophilia, and sexual experience. The study clarifies how these factors mediate one another in relationship to forceful sexual fantasies, and is first to examine the effects of feminist beliefs on forceful sexual fantasy. Adult women (N = 261) participated by completing an online survey. A path from sex guilt to forceful sexual fantasy, mediated by erotophilia, was found, wherein low levels of sex guilt and high levels of erotophilia were found to predict forceful sexual fantasy. A direct path between childhood sexual abuse and forceful sexual fantasy was also found. The resulting model is discussed in relation to previously-proposed theories on the role of force in women's sexual fantasies.

Explorations of lesbian-queer genders

SUMMARY The purpose of this study was to explore the influence of gender expression on queer women's experiences of identity, social interaction and discrimination. This article presents the results of a questionnaire, completed by 149 queer women involved in a southeastern U.S. women's community in which interactions and norms are strongly influenced by butch-femme gendering. Questionnaires ascertained participants' age of first awareness of their queer orientation and their gender expression. In relation to their gender expressions, their experience of discrimination, from both the general population and the lesbian community, was assessed. Participants were asked to specify the degree to which their gender expression was important in their social interactions and to assess the impact of butch and femme identities upon the identifying women and the lesbian community. Results indicated that gender expression may relate to butch and femme women's age of first awareness of sexual orientation and gender expression; experience of discrimination and social interaction; and valuing of butch-femme identification within the queer community.

Differences in ventricular septal motion between subgroups of patients with heart failure

BACKGROUND

Septal systolic motion is determined by the end-diastolic trans-septal pressure gradient, and hence is load dependent.

OBJECTIVE

To explore septal contribution to left ventricular (LV) systolic function in patients with heart failure.

DESIGN

Echocardiograms were identified post hoc from normal subjects and a cohort of patients with heart failure.

PATIENTS

Twelve normal subjects and 69 patients with heart failure and normal conduction or left bundle brance block (LBBB) were studied.

METHODS

Parasternal short axis LV end-diastolic and end-systolic areas were traced. Using a floating centroid, 32 radial chords were constructed, and perecentage shortening from end-diastole to end-systole was calculated for each chord.

MAIN RESULTS

Comparing heart failure with normal conduction and LBBB, LV end-diastolic area was similar (43+/-10 versus 45+/-12 cm(2) not significant), but stroke area was higher in normal conduction (7+/-4 versus 4+/-4cm(2), P<0.05) as was area ejection fraction (0.17+/-0.11 versus 0.10+/- 0.08, P<0.01). In normal subjects, the summed percentage shortening of 10 midseptal chords was similar to that of 10 midfreewall chords (256+/-16% versus 235+/-32%, not significant). In contrast, patients with heart failure and normal conduction had greater midseptal than midfreewall sum med chord shortening (113+/-18% versus 60+/-12%, P<0.05); patients with heart failure and LBBB had paradoxical septal motion (3+/-28, P<0.05 compared with normal conduction).

CONCLUSIONS

Patients with heart failure and normal conduction have an enhanced septal contribution to LV systolic function compared with normal subjects. In heart failure with LBBB, this is lost and the area ejection fraction is lower. Strategies to optimize septal function in heart failure warrant further study.

Pericardial pressure in experimental chronic heart failure

BACKGROUND

In the normal heart, pericardial pressure is greater than previously believed.

OBJECTIVES

To explore the contribution of pericardial constraint to the elevated left ventricular (LV) end-diastolic pressure in chronic heart failure (CHF).

ANIMALS AND METHODS

Pericardial pressure was measured directly in 11 dogs with CHF. Seven dogs were instrumented with LV and right ventricular micromanometers and epicardial pacing leads, and paced at 240 to 260 beats/min for four to seven weeks. After the development of CHF, a left thoracotomy was performed and a flat pericardial balloon was positioned over the LV free wall through a slit in the pericardium.

RESULTS

LV end-diastolic pressure was 31+/-9 mmHg, and pericardial pressure only 7+/-2 mmHg. Nitroglycerin in six dogs decreased LV end-diastolic pressure from 33+/-8 to 28+/-7 and pericardial pressure from 7+/-2 to 6+/-3 mmHg (both P<0.05). Calculated transmural LV end-diastolic pressure also decreased (26+/-8 to 22+/-7 mmHg, P<0.05). Volume loading in five dogs increased LV end-diastolic pressure from 29+/-8 to 42+/-10 mmHg (P<0.05), pericardial pressure from 6+/-3 to 12+/-6 mmHg (not significant) and transmural LV end-diastolic pressure from 23+/-7 to 30+/-7 mmHg (not significant). When the pericardium was opened in three dogs, the LV end-diastolic pressure decreased by 5 mmHg. Four previously uninstrumented dogs were studied to exclude the effects of epicardial scarring; LV end-diastolic pressure was 42+/-6 mmHg and pericardial pressure was 10+/-6 mmHg.

CONCLUSION

Pericardial constraint, a prerequisite for pericardially mediated ventricular interaction, was not present to the same extent in this model of CHF as in acute models, probably reflecting the importance of pericardial remodelling.

Effects of aortic constriction during experimental acute right ventricular pressure loading. Further insights into diastolic and systolic ventricular interaction

BACKGROUND

Acute right ventricular (RV) hypertension may result in hemodynamic collapse. The associated reduction in left ventricular (LV) end-diastolic volume is thought to result from reduced RV output (secondary to RV ischemia) and adverse direct ventricular interaction. Aortic constriction improves cardiac function in these circumstances; this has been attributed to a reversal of the RV ischemia caused by an increased coronary perfusion pressure. We hypothesized that altered ventricular interaction, potentially via altered septal mechanics, may also contribute to the beneficial effects of aortic constriction.

METHODS AND RESULTS

We instrumented nine dogs with ultrasonic dimension crystals to measure RV segment length, septum-to-RV free wall and septum-to-LV free wall diameters, and LV anterioposterior diameter. Catheter-tipped manometers were used to measure LV and RV pressures. Pericardial pressure was measured with flat, liquid-containing balloon transducers. Inflatable cuff constrictors were placed on the pulmonary artery (PA) and aorta, and a flow probe was placed on the PA. The right coronary artery (RCA) was perfused independently by a roller pump calibrated for flow. During moderate PA constriction, while RCA pressure was maintained at control level, RCA flow did not change significantly (15.8 +/- 6.2 to 16.9 +/- 11.5 mL/min) and was similar during severe PA constriction (18.6 +/- 9.8 mL/min). During severe PA constriction, RV stroke volume decreased from a control value of 10.3 +/- 4.9 to 2.3 +/- 1.4 mL/beat (P < .05). When aortic constriction was added while RCA pressure was maintained at control level, there was an increase in RV stroke volume to 4.5 +/- 2.0 mL/beat (P < .05) with no associated change in RCA flow (17.8 +/- 9.5 mL/min). However, pressure-dimension loops clearly demonstrated changes in diastolic and systolic ventricular interaction; with aortic constriction, there was a large increase in the transeptal pressure gradient associated with a rightward septal shift. During either isolated severe PA constriction or simultaneous severe PA and aortic constriction, RCA flow was increased until RCA pressure was approximately equal to that in the aorta. This produced an increase in RCA flow of 50% (P < .05); however, this increase in coronary flow was ineffective in improving any measure of RV function.

CONCLUSIONS

In this model of acute RV hypertension, aortic constriction improves cardiac function, at least in part, by altering ventricular interaction independent of changes in RCA flow. Changes in RCA flow do not appear to have a significant impact on cardiac function in this model in which coronary artery pressure was maintained at normal or increased levels.