We investigated whether right ventricular infarct size is increased in the hypertrophied right ventricle. In dogs, we produced chronic pressure overload-induced right ventricular hypertrophy (RVH) and acute pulmonary stenosis (APS) with a similar right ventricular systolic pressure to RVH. Then, in an open-chest model, right coronary artery occlusion for 4 h followed by 1 h of reperfusion was performed in animals with RVH or APS or in controls. Regional myocardial blood flow was measured with nonradioactive colored microspheres. Compared with the control group, regional myocardial oxygen consumption in the right ventricle was increased in the APS but not in the RVH group. The risk area and collateral blood flow were comparable in the three groups. However, the infarct size relative to risk area was increased in the APS group (42.3 +/- 4.9%), but that in the RVH group (21.1 +/- 4.4%) was not different from controls (26.1 +/- 4.2%). Thus right ventricular infarction in the heart with RVH was not increased compared with the normal heart.